Table of Contents
Winter 2003/ Volume 21, Number 1

 Features 
Obstructive Sleep Apnea in Head and Neck Cancer Patients Post Treatment...

Something to Consider
Cheryl Koliha, BSN, RN

 Efficacy of Video Education for Patients and Caregivers
Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN

 Departments

Editorial: The Best Practice Approach

Linda K. Clarke, MS, RN, CORLN
 

Presidential Perspectives: SOHN Members, Where Are You?
Linda Miller Calandra, MSN, CPNP, CORLN
 

Media Review: Heroes
Heather Rebic, BS, RN
 

Of Speciality Interest:
Steps to Successfully Produce Educational Video

Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN
 

Spotlight on Research:
Home Care for Chronic Respiratory Failure in Children

Feature Editor: Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN
Reviewer: Mary Klein, MS, RN

 Practice Management:
Telephone Triage in an Otolaryngology Practice

Feature Editor: Kimberly J. Pollock, RN, MBA
Mary LeGrand, RN, MA

 Patient Education: Tips for Smoking Cessation
Janice F. Adams, BSN, MPA, CNA, CORLN
 

Obstructive Sleep Apnea in Head and Neck
Cancer Patients Post Treatment ... Something To Consider?

Cheryl A. Koliha, RN, BSN

Abstract…
Obstructive sleep apnea (OSA) occurs due to enlarged tissue such as tonsils, base of tongue or palate, pharyngeal space narrowing, or decreased muscle tone of the pharyngeal dilator muscles.  Treatments for head and neck cancer may cause physical changes resulting in OSA. Based on recent anecdotal experience and limited research available looking at the incidence of OSA in post treatment head and neck cancer patients, assessment for signs and symptoms of OSA by otorhinolaryngology nurses seems warranted. Prompt diagnosis and treatment of OSA in the patient with head and neck cancer may significantly improve the person’s health and quality of life.

EFFICACY OF VIDEO EDUCATION FORPATIENTS AND CAREGIVERS
Helene J. Krouse, Ph.D., APRN, BC, CORLN, FAAN

Abstract…
Videotapes are valuable resources for assistance in educating patients and caregivers in today’s changing health care environment. Videotapes can be effective teaching tools for patients by facilitating knowledge acquisition, reducing anxiety, improving coping skills, and enhancing self care behaviors. They incorporate visual and auditory information into a teaching modality that is often easier for individuals to understand and retain. Research on videotaped patient education will be presented with application of findings to the practice of otolaryngologic nursing.

 Practice Management: Telephone Triage in an Otolaryngology Practice
Mary LeGrand, RN, MA

Abstract…
Telephone triage is not a new healthcare concept, but it is an idea that is gaining momentum as Americans move into today’s "e-technology, e-health" world. In fact, many companies are creating systems and protocols to improve efficiency and increase access to "triage" personnel.

  

Table of Contents
Winter 2003/ Volume 21, Number 2

 Features

 Utilization and Perceived Benefits of Postoperative Otology In-Service Training for Inpatient Nurses
Cherie A. Smith-Miller, M.Ed., BSN, RNC, NCSN

 Departments 

Editorial: Bernie's Gift
Linda K. Clarke, MS, RN, CORLN

 Presidential Perspectives: The ABCs of Bridge Building
Linda Miller Calandra, MSN, RN, CPNP, CORLN

 Best Practice Forum:
Standard High Level Disinfection Protocol Development

Cindy J. Dawson, BSN, RN, CORLN
Ruth Nielson, BSN, RN, CORLN

 Highlights from the Hill:
NIWI: The Nurse in Washington Internship Program—
A Call to All SOHN Members

Ann P. Luther, MSN, RN, CS, Cm, CORLN
Ann T. McKennis, RN, CNOR, CORLN
Patricia Orta, RN, AD, BS

 Media Review: Tools for Clinicians
Heather Rebic, BS, RN

 Of Specialty Interest:
The Food and Drug Administration: A Partner in Safe Practice

Karen Baker, MSN, RN

 Spotlight on Research:
Psychosocial Intervention for Newly Diagnosed Cancer Patients

Feature Editor: Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN
Reviewer; Mary Jo Dropkin, PhD, RN, CORLN

 Utilization and Perceived Benefits of Postoperative Otology In-Service Training for Inpatient Nurses
Cherie A. Smith-Miller, M.Ed., BSN, RNC, NCSN

Abstract…
This study examined the perceived effectiveness of in-service training (IST) to improve the nursing care of post-operative otology patients as a function of nursing experience. IST was administered to four distinct units in a large university hospital, examining nurses with a range of experiences in otology care. An eight item IST evaluation instrument was developed, administered, and validated for this study. The results of this study indicate the following: a variation existed among units in the receptiveness to IST; a 15-20-minute IST session significantly improved the perceived ability to deliver quality patient care; similar effectiveness of the IST was observed for all otology care groups; and an oral IST approach was more effective than a self-study approach. Further, we found that IST increased awareness and utilization of specialty support services.

 Best Practice Forum: Standard High Level Disinfection Protocol Development
Cindy J. Dawson, BSN, RN, CORLN
Ruth Nielson, BSN, RN, CORLN

Abstract…
Gluteraldehyde-based high-level disinfection (HLD) poses significant safety risks for staff and patients as well as institutional cost concerns. A value analysis team reviewed HLD practices, available products, and environmental requirements in viewof the literature and standards developed by the Occupational Safety and Health Administration (OSHA). Institutional areas were identified and standardized unit-specific educational and competency programs were established. The overall use of gluteraldehyde-based HLD was decreased in this institution based on the findings and policy and procedure modification.

  Highlights from the Hill: NIWI:
The Nurse in Washington Internship Program—A Call to All SOHN Members

Ann P. Luther, MSN, RN, CS Cm, CORLN
Ann T. McKennis RN, CNOR, CORLN
Patricia Orta, RN, AD, BS

Abstract…
Recent findings from the membership survey conducted in 2002 by the Society of Otorhinolaryngology and Head-Neck Nurses (SOHN) revealed that many members of SOHN were unfamiliar with the Nurse in Washington Internship program (NIWI). SOHN has been participating in the NIWI endeavor since the late eighties. To date, SOHN’s NIWI interns have been either active members of the Government Relations Committee or the President-Elects of the Society. At the January 2003 Mid-Winter Board Meeting, the Board of Directors voted to expand the opportunity for participation in NIWI to SOHN’s members-at-large. This article provides a brief overview of the NIWI program and describes the plan for extending this opportunity to the general membership.

Of Specialty Interest: The Food and Drug
Administration: A Partner in Safe Practice

Karen Baker, MSN, RN

Abstract…
Have you ever wondered what really goes on at the United States Food and Drug Administration (FDA)? At each meeting of the Society of Otorhinolaryngology and Head-Neck Nurses(SOHN) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) the FDA is repeatedly mentioned, and not always favorably! This article discusses the process of bringing new medical devices to market and explains how ORL (or ENT) nurses can contribute to the protection of the public health by providing medical device adverse event information to FDA.
 

 

Table of Contents
Winter 2003/ Volume 21, Number 3

 Features

 Intratympanic Therapy for Sensorineural Hearing Loss and Vertigo
Sam Marzo, M.D.

 The Tympanic Membrane: See It, Describe It, Treat It
Keith McDivitt, MSN, RN, FNP, CORLN

 Refeeding Syndrome
Ellen Ladage, RD, CNSD, LDN

 Departments 

Editorial: The Entry into Practice Debate
Linda K. Clarke, MS, RN, CORLN
 

Presidential Perspectives: What’s Your Position?
Linda Miller Calandra, MSN, CPNP, CORLN
 

Practice Management: Billing for Nurse Practitioner Services
Kimberley J. Pollock, RN, MBA
 

Highlights From the Hill: AAO-HNS Government Relations Briefing
Day on Capital Hill: A Nursing Perspective

Ann T. McKennis, RN, CNOR, CORLN

 Media Review: Head and Neck Oncology Resources
Heather Rebic, BS, RN

 Spotlight on Research: Information Needs of Elderly Postsurgical
Cancer Patients During the Transition from hospital to Home

Feature Editor: Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN
Reviewer: Joan Such Lockhart, Ph.D., RN, CORLN, AOCN®, FAAN

 Patient Education: Swimmer’s Ear
Linda T. Schuring, MSN, RN

 Practice Management: Billing For Nurse Practitioner Services
Kim Pollock, RN, MBA

Abstract…
Utilization of Nurse Practitioners (NPs) in otolaryngology practices is increasing. Otolaryngologists now employ NPs to assist with patient care responsibilities in a variety of settings, from solo practice to large academic groups. This article addresses the appropriate third-party billing methods for NP services.

Intratympanic Therapies for Sensorineural Hearing Loss and Vertigo
Sam J. Marzo, M.D.

Abstract…
The theory behind intratympanic therapy is that by instilling small amounts (<0.5 cc) of medications into the middle ear, absorption into the inner ear occurs though the round window. The medicines exert their effects on the cochlear and vestibular end organs. The benefits of these therapies include: control of systemic side effects, and the ability to treat the patients in the clinic or outpatient setting with encouraging results. The purpose of this paper is to explain the potential role of intratympanic therapy in treating specific inner ear disorders.

 The Pediatric Tympanic Membrane: See It, Describe It, Treat It
Keith McDivitt, MSN, RN, FNP, CPRLN

Abstract…
Acute otitis media (AOM) is one of the most common childhood conditions for which antibiotics are prescribed, often unnecessarily. Current medical literature focuses on the treatment of AOM, appropriate antibiotics, and antibiotic resistance. Placing more emphasis on examination and description of the tympanic membrane (TM) reduces the over diagnosing of AOM and concerns associated with antibiotic use. A thorough examination of the ear must be performed in order to make an accurate diagnosis. This article presents a three-step technique to assist providers to perform pneumatic otoscopy, visualize the TM, describe their findings, and subsequently treat AOM.

 Highlights from the Hill:

AAO-HNS Government Relations Briefing Day on Capitol Hill: A Nursing Perspective
Ann T. McKennis, RN, CNOR, CORLN

Abstract…
It is a well-known fact that to promote an issue in the political arena, a coalition or group of people desiring the same thing has more power than a single entity. I have seen the results in my home state of Texas when the Nursing Government Relations Coalition of which the Society of Otorhinolaryngology-Head and Neck Nurses (SOHN) is a member, the Texas Hospital Association, and the Texas Medical Association all work together to pass legislation. As Chair of the Government Relations Committee (GRC) it was with this in mind that I requested to attend the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Government Relations Briefing Day in Washington, D.C. on March 11, 2003. Executive Director Sandra Schwartz and President Linda Miller Calandra were also in attendance. This article provides an overview and personal perspectives of this event.

 Refeeding Syndrome
Ellen Ladage, RD, CNSD, LDN

Abstract…
Refeeding syndrome can occur when nutrition is reinstituted in a starved patient and, if abnormalities are not corrected, can be lethal. This article describes metabolic adaptations to starvation, risk factors for the development of refeeding syndrome, and causes as well as symptoms of refeeding syndrome. Adverse consequences of hypophosphatemia, hypomagnesemia, and hypokalemia are described, and nursing implications to prevent refeeding syndrome are outlined.

 

Table of Contents
Winter 2003/ Volume 21, Number 4

 Features 

SOHN Web-Based Membership Survey: Results, Analysis, and Recommendations
Susan F. Rudy, MSN, CRNP, CORLN
Helene J. Krouse, Ph.D., APRN, BC, CORLN, FAAN
Margaret M. Hickey, MS, MSN, RN, OCN
®, CORLN
Ann P. Luther, MSN, RN, CS, Cm, CORLN
Carolyn P. Waddington, MS, RN, FNP-C, CORLN

Implantable Hearing Devices
Sam Marzo, M.D.

 Departments 

Editorial: Medical Marijuana: Politics Vs Patient Care
Linda K. Clarke, MS, RN, CORLN

Presidential Perspectives: The Awards and Rewards of ORL Nursing
Linda Miller Calandra, MSN, CPNP, CORLN

 How I Do It: A Technique for Oral Wound Irrigation Following Maxillectomy and Mandibulectomy
Mark S. Chambers, D.M.D., MS

 
James C. Lemon, D.D.S.
Jack W. Martin, D.D.S., MS

 Highlights From the Hill: A United Voice for Nurses
Feature Editor: Helene J. Krouse, Ph.D., APRN, BC, CORLN, FAAN

 Media Review: Oncology Care Resources
Heather Rebic, BS, RN

 SOHN 2002 Web-Based Membership Survey:
Results, Analysis and Recommendations

Susan F. Rudy, MSN, CRNP, CORLN
Helene J. Krouse, Ph.D., APRN, BC, CORLN, FAAN
Margaret M. Hickey, MS, MSN, RN, OCN, CORLN
Ann P. Luther, MSN, RN, CS, Cm, CORLN
Carolyn P. Waddington, MS, RN, FNP-C, CORLN

Abstract…
In March 2002, the Society of Otorhinolaryngology and Head-Neck Nurses, Inc. (SOHN) conducted a web-based survey of members’ knowledge of and satisfaction with its portfolio of products and services. This paper reports on the process of developing and conducting the survey, as well as its findings. A new "Volunteer Agreement / Code of Conduct", piloted for this team’s work is introduced. General and specific recommendations are put forth for SOHN members and leaders, including useful information to facilitate work for future survey teams.

 Implantable Hearing Devices
Sam J. Marzo, M.D.

Abstract…
Hearing loss remains the most common sensory impairment in the United States. Fortunately, new treatments for this disorder are becoming available each year. This article reviews the human ear anatomy, types and causes of hearing loss, and presents basic information on middle and inner ear implantable hearing devices. Risks, benefits, costs, and nursing care issues are discussed.

 How I Do It: A Technique for Oral Wound Irrigation Following Maxillectomy and Mandibulectomy
Mark S. Chambers, D.M.D., M.S.
James C. Lemon, D.D.S.
Jack W. Martin, D.D.S., M.S.

Abstract…
Background: Numerous devices have been recommended for ensuring appropriate hygiene and care of wounds resulting from maxillectomy and mandibulectomy. This article describes an irrigation device for use in the oral cavity after these procedures. Methods: The system consists of a prepackaged, disposable, 50-cc piston syringe; a nonconductive connecting tube, and a saliva ejector that can be assembled for oral irrigation. Results: The modified piston syringe allows physicians, nurses, and patients to efficiently irrigate mucosal wounds, maxillary or andibular defects, and oropharyngeal or oral and pharyngeal wounds. Conclusion: This system is efficacious, more adaptable, and less expensive than other self-irrigating gravimetic instruments and is thus recommended for use in patients who have undergone maxillectomy or other ablative procedures in the oral cavity.

 Highlights from the Hill:  A United Voice for Nurses
Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN

Abstract…
The Nurse in Washington Internship (NIWI) is a wonderful opportunity for members of the Society of Otorhinolaryngology and Head-Neck Nurses (SOHN) to experience the political process first hand while making a difference in the lives of others. As President-Elect in 2003, I was asked to represent SOHN at NIWI, 2003. I share with you my perspectives based on this unique experience.