As a result, the federal Centers for Disease Control and Prevention (CDC) will formally advise health professionals on Oct. 6 that fall vaccination efforts focus primarily on person over age 64, the chronically ill and health care providers. These are the groups that are at greatest risk of succumbing to the flu or spreading it to others.

In response, the Advisory Committee on Immunization Practices (ACIP) has urged health care providers to consider postponing adult mass influenza vaccination campaigns until November, or about a month beyond their usual starting dates. And healthy persons - including those ages 50 to 64, who are generally considered "high risk" -- are being asked to postpone getting vaccinations until November or December. However, the recommendations are not binding, and doctors are allowed to give shots at will.

A delayed vaccination schedule is still expected to protect most people, especially if the coming flu season does not peak until January or later, as it generally has in the past.

(Source: The Washington Post, 9/29/00)

This workshop has been sponsored through the National Vaccine Advisory Committee. The purpose of the workshop is to provide a forum for identifying and discussing more effective approaches to vaccine benefit and risk communication. The objectives are as follows:

• To identify key issues, forces and trends that are influencing and shaping perceptions about vaccines.
• To determine how to establish meaningful discussions regarding issues of concern.
• To define options for establishing more effective approaches for communicating vaccine benefits and risks.
• To examine and discuss the effectiveness, purpose, methods, and timing of current vaccine communications.

The target audience is broad, and aims to attract health communication and Education specialists from a variety of arenas. These include:

Communication & Public Affairs Specialists Health Care Providers Consumer & Parent Groups Immunization Program Directors & Managers Health Researchers Health Education Specialists Vaccine Manufacturers

One of the biggest challenges that the profession faces is attracting young people into nursing, and the biggest barrier that nursing students and potential nursing students face is funding for nursing education. The Foundation of the National Student Nurses Association has established a Capital Campaign to raise scholarship funds for nursing students, and the Nurse Betty Scholarship Fund will help to fulfill this promise by providing financial support for undergraduate nursing education.

“It is our understanding that this conditional veto authorizes the Department of Health in consultation with the Department of Labor to conduct hearings to set forth regulations for mandatory overtime and voluntary overtime,” stated Andrea Aughenbaugh, RN, CEO of the New Jersey State Nurses Association (NJSNA).

Understaffing at the facility has resulted in nurses being routinely assigned more patients than they can safely cover, being mandated to work overtime and being “floated” to areas outside their clinical expertise with no orientation. The ANA issued a statement in support of the nurses prior to the strike and called on the Washington Hospital Center to give the nurses a voice on the hospital committees that examine the resources needed for patient care so that those providing direct patient care can prevent inadequate and inappropriate staffing.

Since the strike began, the nurses have received significant media coverage. The strike was featured during a segment on ABC’s “Good Morning America” that discussed overworked Americans on Wednesday, Sept. 19. The following day, one of the striking nurses and United American Nurses Chair Cheryl Johnson, RN, were featured callers on public radio’s “Diane Rehm” show, which discussed mandatory overtime. Several members of the ANA board and other ANA and CMA leaders have been on hand to lend their support to the striking nurses. ANA Board Member A. Louise Hart, DNS, MSN, RN, spoke to the media during a Sept. 20 press conference on the strike line along with Gwen Johnson, RN, president of the DCNA E&GW Cabinet. Hart was also interviewed by WJLA-TV, the Washington, DC, channel 7 affiliate. On Sept. 21, ANA President Mary E. Foley, MS, RN, and CMA leaders who were in Washington for the strategic governance training sessions, joined DCNA nurses on the picket line. The following day, Foley and Johnson presented a check from the ANA to the striking nurses.

Open Door 2000: Levels of Certification
Certification is a means of measuring competency, and the identification of competent nurses will promote the public welfare for quality in health care.

Certification is based on education and recognition of knowledge, skills, and abilities or competence, developed through experience in a specialty area of practice. Both formal educational preparation and competence in practice are key criteria for all certification programs regardless of discipline.

ANA and ANCC continue to support the baccalaureate degree in nursing as the entry-level into practice.

The framework for Open Door 2000 includes two (2) major credentialing levels: "certification" and "board certification" based on educational degrees achieved and recognition of competence developed through practice experience. It further adapts a model used by other health professions such as medicine that confers "board certification" for those who meet a pre-defined level of educational preparation for practice and as well as demonstrate competency in practice. (In the case of medicine, pharmacy, and other health professions, graduate educational preparation is required for entry to practice and to sit for board certification examinations.) The designation of "board certified" is a recognition of both educational and practice competency of the highest order in the profession. ANCC confers the credential of RN,C (Certified) for diploma and associate-degree prepared nurses who demonstrate competency at that level of practice, and RN,BC (Board Certification) for nurses who have a baccalaureate or higher degree in nursing and demonstrate competency at that level of practice.

Board level certification is awarded by the Board on Certification for Baccalaureate Nursing Practice and the Board on Certification for Advanced Nursing Practice. Certification is awarded by the Committee on Certification for Diploma and Associate Degree Nursing Practice. Both the two Boards and the two Committees are separate entities within the ANCC structure. These credentials distinguish between levels of certification within the profession and to our consumers, and continue to support the baccalaureate in nursing as entry level into practice.

Implementation of the New Credentials
The first administration of the two levels of certification will occur during the June 24, 2000 testing date. The candidates who become certified from these exams will be the first to receive the new credentials RN,BC or the new designation of the RN,C. If the certified nurse does not possess a bachelors degree in nursing she/he are not authorized to use the RN,BC.

There are several situations which might arise in which a nurse would be authorized to change the credential they previously were awarded by ANCC. If a nurse sat a previous exam, held a BSN and was awarded an RN,C, she/he may now use the new credential RN,BC and will receive a new certificate upon recertification and validation of the bachelors degree. If a new certificate is required or desired before the recertification period, the nurse can apply for this by downloading a form from the website or calling 1-800-284-2378 to request a "Change of Credential" form and submitting it along with $15.00 for administrative costs to ANCC. In this case the nurse had already met the initial requirements of the exam and is authorized to use the new credential (RN,BC).

If a nurse sat a previous exam without a BSN and earns the BSN during the five year recertification cycle she/he may either (1) wait for the recertification period to apply for the new credential by showing proof of the degree and receive the new certificate or (2) apply for a new certificate early as outlined above, show proof of the bachelors degree in nursing, and submit $15.00 to ANCC for administrative costs.

If a nurse takes one of the new leveled exams without a BSN but during the recertification period earns the BSN, the situation is similar to options one and two described above.

Advanced Practice
In addition to the two credentials above, a new credential has been approved by the Commission on Certification for use by advanced practice nurses, both nurse practitioners and clinical nurse specialists. This credential is APRN,BC. The advanced practice nurse can use this credential or attach the "BC" component to the designation required by the state in which she/he practice if so desired. Examples might be:

ACNP, BC
CRNP, BC
ARNP,BC
NP-BC
CS, BC

The advanced practice nurse can use the new credential now but will not receive a new certificate until recertification. If the nurse desires a new certificate now for their office or other purposes, she/he may order one for $15.00 as outlined above. Proof of education is not required since graduate education was required for initial certification.

Nursing Administration
Nurse administrators will continue to use the CNA and CNAA with the "BC" (Board Certification) becoming CNA,BC and/or CNAA,BC.

Modular Certifications
Modular certifications are considered additions to a basic certification or core and are governed by the Committee on Modular Certification. The credential awarded to these nurses in the past was "Cm", but now will be RN,C.

**"Change of Credential" form [PDF format]

Foley touched upon the importance of changing the work environment for in September on Eye on America. “Many hospitals have made financial decisions that have reduced the RN workforce,” said Foley. Foley emphasized that nurses are being forced to work mandatory overtime, several hospitals have been charged with unsafe staffing practices and nurses are required to manage higher patient workloads even when patient acuity seems to be rising.

In addressing questions on the impending nursing shortage, Foley reported that recruitment alone will not solve the problem. “Health care organizations need to be involved in pursuing strategies to not only recruit but to retain nurses,” stated Foley. Fixing the work environment as well as developing strong educational programs and increasing interaction with the youth to promote nursing as a career were only a few suggestions offered. “We need to reinforce the fact that nursing is an exciting

For details, contact Andrea Aughenbaugh (609-883-5335) the New Jersey State Nurses Association (NJSNA).

The summit, sponsored by the Quality Interagency Coordination Task Force (QuIC), was part of the federal government's response to last year's Institute of Medicine (IOM) report, which noted that up to 98,000 patients are killed each year from medical errors. Participating in the government hearing were panelists representing consumers, purchasers, doctors, pharmacists, health care systems managers, federal and state agencies and public policy experts.

Citing the IOM study, Underwood noted that an examination of the full range of staffing issues was largely missing from the report's findings. Among those issues, Underwood said, is the alarming incidence of mandatory overtime currently being used to fill gaps in staffing.

Themes that emerged from the conference included the need to create a culture of safety in healthcare; the need to take a systems approach to preventing medical errors rather than punishing individuals; the need to establish an adequate reporting system; and the need to take a look at errors in outpatient as well as inpatient settings.