HIMSS 2022: When Nurses Reimagine Health Care

  

ANA staff attended the 2022 Health Information and Management Systems Society (HIMSS) conference last week where reimagining health and the health care delivery system were top of mind. The week started by reimagining health with a NursePitchTM Innovation event. ANA’s Innovation Department collaborates with HIMSS by setting the stage for nurses to share their creative business ideas and programs to a team of judges, who are health innovation, business, and industry leaders. ANA knows that nurses have important ideas and approaches that can positively change the health delivery system and we encourage them to learn more and be ready to present at an event in the future!

It would be an understatement to say that the nursing workforce was top of mind in discussions around reimagining health. Attendees at HIMSS22 represent a microcosm of the health sector and have been living during the seismic shift that the delivery system has done over the past two years. The COVID-19 pandemic has triggered the need to adapt to new treatments, delivery options, and other environmental factors. Another key focus for the health care industry is developing new ways to support providers facing the challenges of today and the hope of the health system of the future. Digital tools can help with flexible scheduling, reduce duplications in workflow, and assist in charting. However, ANA continues the drumbeat about the importance of health systems valuing nurses through reimbursement, safe work environments, and ensuring each and every nurse achieve health equity in order to meaningfully solve the staffing crisis.

Over the course of the pandemic, we have also seen reports of the increase in digital technologies to deliver health services. The increased use happened seemingly overnight and is unlikely to return to pre-February 2020 levels ever again. At the same time, we must reflect and address the existing digital divide. Investments in our workforce must reflect the patient population in every community is vital, but we also need to make sure that the digital tools that are being used to assist in clinical decision making are free from unintentional biases. Just as important for patients, we must also ensure that nurses have access to the same opportunities to reach their own health equity—the nation cannot have a workforce that is shut off from the same system they provide care in.

Attending the HIMSS 2022 conference provided a great opportunity to learn, connect, and share ideas with others working to better the health care delivery system. The one thing missing was nurses on the big stage. ANA knows that nurses have stories, research, and ideas to share and together, we must be bold, step forward, and ensure our voices are heard in front of industry leaders as we all work to shape the health delivery system of the future.

H.R. 3635 Promises to Strengthen PPE Stockpile for Future Emergencies

  

This Capitol Beat article was guest-written by Debbi Waters, MSN, RN, MJ, CHC, a student in the McKendree University Doctor of Nursing Practice (DNP) in Ethical Leadership Program, who is completing her leadership practicum in partnership with ANA Senior Policy Advisor Lisa Stand.

This month, Congress took a positive step in preventing a repeat of the catastrophic shortages of personal protective equipment (PPE) experienced by nurses at the outset of the COVID-19 pandemic. With bipartisan support, the House of Representatives passed H.R. 3635, the Strengthening America’s Strategic National Stockpile Act of 2021.

It has been nearly two years since the COVID-19 pandemic began to rapidly spread across the United States (U.S.), triggering the worst public health emergency the nation has witnessed in more than a century. From the beginning of the pandemic in 2020, nurses quickly found themselves fearing for their personal safety, as well as the safety of their patients and families, as PPE supplies were being depleted at an extraordinarily fast pace. Nurses on the frontlines were directed to abandon evidence-based infection prevention standards, for instance, by being required to wear the same PPE for extended periods of time, and to reuse PPE across multiple shifts. In an American Nurses Association (ANA) survey in May of 2020, 45 percent of nurses reported experiencing PPE shortages, with 79 percent of nurses reporting being encouraged or required to reuse PPE, of those 59 percent felt unsafe in doing so. The ANA completed a second survey, ending on August 14, 2020, with 47 percent of nurses reporting intermittent to occasional PPE shortages. Forty-two percent of participating nurses reported an increase in PPE availability, as compared to 36 percent reporting no change; however, 68 percent continued to report being required by their facility to reuse single-use PPE, with 62 percent reporting feeling somewhat to very unsafe. The enormity of the impact of COVID-19 on healthcare workers is yet to be determined; however, the failure to provide basic PPE to frontline nurses and healthcare workers was profound and consequential to physical and mental well-being of our nation’s nursing workforce.

Why is H.R. 3635 Important?
H.R. 3635 would address key vulnerabilities within the federal government’s ability to adequately respond to such large-scale public health emergency, particularly with the medical supply chain.

The U.S., as with most other countries around the globe, utilized unprecedented amounts of PPE during the COVID-19 pandemic. At times, the PPE burn rate was nearly a 100 percent increase over historical levels. Very early in the pandemic as hospitals exhausted PPE supplies and began experiencing challenges in purchasing supplies through the usual “just in time” supply chain channels, and as local and state supplies became depleted, states called up the federal government for assistance through the Strategic National Stockpile (SNS)

The SNS, long considered to be the contingency plan for public health emergencies, was ill-prepared to respond to a threat the size and scope of this pandemic, certainly not for a threat simultaneously affecting all 56 states, territories, and the District of Columbia. The SNS endured years of underfunding and budget cuts by Congress that, compounded by a failure to replenish and rotate stock, led not only to inadequate amounts of PPE, but also to the delivery of PPE that was expired, rotting, and inappropriate for safe use in protecting nurses from the dangers of COVID-19.

Maintaining the Stockpile
H.R. 3635 would address the issue of expired and unsafe supplies by allowing the U.S. Department of Health and Human Services (HHS) to distribute supplies from the SNS to any federal department or agency, on a reimbursable basis, if the supplies are within one year of expiration and can be replenished within the SNS. In addition, HHS would be required to ensure that supplies and equipment within the SNS are in working order.

Domestic Production
The COVID-19 pandemic also exposed the risks associated with U.S. dependence on foreign sources for nearly 60 percent of the nation’s medical supplies. This dependence created cataclysmic sourcing and price challenges for American hospitals and healthcare providers, caused by stockpiling of supplies and price gouging, at one point upwards of 1,000 percent the customary cost, for supplies that were of poor quality and at times counterfeit. The inability of domestic manufacturing proved to be detrimental to nurses who were providing care to COVID-19 patients. H.R. 3635 calls for the creation of a pilot program designed to strengthen the U.S. supply chain by increasing domestic manufacturing. Specifically, the pilot requires HHS to establish and maintain geographically dispersed domestic reserves of critical medical supplies, including PPE, and increased emergency stock of those critical supplies through cooperative agreements or partnerships with manufacturers to produce and maintain supplies. Additionally, the bill provides temporary authorization for HHS to disperse grants to states for use in maintaining or expanding state strategic stockpiles of critical supplies that are deemed essential by the State in preparation for future public health emergencies.

Transparency and Tracking
Strengthening America’s Strategic National Stockpile Act of 2021 would require HHS to develop a transparent process for distribution and use of supplies from the SNS by January 1, 2022. This would include a process for states, localities, tribes, and territories (SLTT) to request supplies; the decision-making process HHS will follow when determining if the request will be fulfilled or denied; and the process for the prioritization of distribution to the SLTT. In addition, the bill would require a monthly report to be provided detailing the requests submitted by SLTT, including the amount of materials and supplies requested, along with the outcomes of those requests. In the event a supply request is only partially filled or denied, the rationale for those outcomes must be included.

Our nation must begin building upon the lessons learned during the COVID-19 pandemic by planning and preparing a response to future public health emergencies. We must remain vigilant, as COVID-19 will not be an isolated incident, if we are going to prevent a repeat of the catastrophic failures experienced during the COVID-19 response. H.R. 3635 is a positive step towards ensuring the U.S. response to upcoming public health emergencies will be more efficient and effective, while protecting the health and safety of our frontline healthcare workers and we thank Representative Elissa Slotkin for her leadership in addressing this critical issue.

Next Steps
There is still work to be done to ensure the Strengthening America’s Strategic National Stockpile Act of 2021 is signed into law. This legislation now moves to the Senate where a companion bill S.1974 was introduced in June 2021. As you know, things tend to move slowly in the Senate and they need a groundswell of support from their constituents to pass legislation. Without action, nurses will be no more protected in future pandemics, than we were in March of 2020. Please visit our Latest News page for updates on the legislation and a chance for every nurse and health care advocate to take action and message their members of Congress soon.

FY 2022 budget proposal sets the stage for Biden administration

  

The Biden administration released its proposed FY 2022 budget, which helps bring some clarity to the continued priorities of the administration. The budget reflects the administrations promise to rebuild a strong public health and community-based care system that can respond to the health challenges faced in diverse areas across the United States. Many priorities of the administration align with ANA’s advocacy focus to support nurses in areas such as workforce, behavioral health, maternal health, rural health, preparedness and safety including personal protective equipment (PPE), and research.

Below are a few highlights from the proposed budget that align with the work of ANA:

  • $15.4 billion for the Centers for Disease Control and Prevention, which reflects the largest budget authority increase in nearly two decades. The funding would go to support core public health capacity improvements, modernize data collection, training for public health experts, and prepare for, and respond to emerging global threats.
  • $12.6 billion for the Health Resources and Service Administration, which is $497 million above FY 2021 enacted.
  • $52 billion for the National Institutes of Health (NIH), an increase of $9 billion above FY 2021 enacted. $6.5 billion of the $9 billion increase is to support the establishment of the Advanced Research Projects Agency for Health, that is intended to speed transformational innovation in health research for diseases like cancer, diabetes, and Alzheimer’s. The remaining $2.5 billion will continue the research and translation into clinical practice for some of the most urgent challenges including the opioid crisis, climate change, and gun violence. ANA continues to monitor communications and opportunities to engage with the National Institute of Nursing Research under NIH.
  • An increase of $3.7 billion above FY 2021 enacted, for a total of $9.7 billion for the Substance Abuse and Mental Health Services Administration with a charge to respond to the opioid and substance use epidemic by expanding programs and targeting prevention and treatment; and increasing access to mental health services to protect the health of children and communities.
  • $14.2 billion for the Department of Labor (DOL), including $665 million for the Occupational Safety and Health Administration (OSHA), $73 million above FY 2021 enacted, for increased enforcement and whistleblower protection programs. The DOL budget requests $285 million for apprenticeship programs, specifically $100 million increase for the Registered Apprentice Program. There is no additional information on the DOL industry-recognized apprenticeship programs (IRAPs), which have supported nurse training initiatives.

The Biden administration has been vocal about priorities that will transform the health care system. However, the administration’s budget is slightly more than a wish list. Ultimately it is up to Congress to fund the agencies. ANA urges the Administration and Congress to focus on rebuilding and transforming the health care system to improve on the challenges brought forth during the pandemic. Nurses have been the agents of transformative change in facilities, systems, and communities to support improved patient outcomes and advancing equity. Building on these successes, ANA will work with the agencies and administration to build on the budget priorities to continue to put nurses at the forefront of change.  

ANA is also working on the Hill for legislation that will address infrastructure and access for telehealth services, PPE for the current and future public health emergencies, and workplace safety programs for nurses. ANA’s advocacy includes a multi-pronged approach to deliver what nurses need in all settings. It is clear through the first budget of this administration that health care is a top priority to improve as we transition to a post-pandemic environment.