TOPIC: INCREASING AWARENESS OF THE NEED TO IMPLEMENT LEGISLATION THAT

MANDATES REAR-FACING CAR SEAT USAGE

SUBMITTED BY: Seminole State College Student Nurses’ Association

City/State: Orlando, FL

AUTHORS: Brittany FitzGerald, Lily Coble, Muna Abdulrahim, Bryan Garland, Hazel Go

WHEREAS, “the leading cause of death in children under 19 years old is motor vehicle
crashes” (Smola, et. al, 2020); and
WHEREAS, looking at patterns of injury for children in a head on collision suggest that front- facing
car seats expose children to a greater risk of spinal injuries and death when compared to
rear-facing car seats (Gan, et. al, 2019); and
WHEREAS, children up to 23 months old have a 75% reduced chance of dying or sustaining
a serious injury in a rear-facing car seat than a forward-facing one. Rear-facing car seats
spread the force of the crash more evenly throughout the back of the car seat and the
child’s body. While also, limiting the motion of the head which reduces the risk of neck
injury (Thomas, 2016); and
WHEREAS, the American Academy of Pediatrics recommends the best practice for all
children is to remain in a rear-facing car safety seat until the age of 2 years or until they
reach the maximum weight or height allowed by their car seat
Manufacturer (Durbin, 2011, p. 789); and
WHEREAS, the National Highway Traffic Safety Administration recommends children ages
1-3 to remain rear-facing for as long as possible (Car Seats and Booster Seats 2020) ; and
WHEREAS, despite AAP and NHTSA recommendations, up to 75% of children are
transported in forward-facing car seats earlier than recommended due to the lack of
communication between public health researchers, advocates, citizens, and legislators
(Huang, 2019, p. 9-10); therefore be it

RESOLVED, that the Florida Nursing Student Association (FNSA) encourages its constituent

chapters and members to advocate and raise awareness about the need to

increase child motor vehicle safety by mandating rear-facing car seat usage per

recommendation by the American Academy of Pediatrics and the National

Highway Traffic Safety Administration; and be it further

RESOLVED, that the FNSA and its constituents contact government representatives at the

local and state level in order to lead a call to action to increase awareness of the

importance of creating legislation that supports rear-facing car seats usage for

as long as possible and/or until the child has reached the maximum height or
 weight per car seat manufacturer; and be it further

RESOLVED, that the FNSA publish an article in the FNSA Hotline on this topic; and be it

further

RESOLVED, that the FNSA send a copy of this resolution to the Florida Nurses Association,

Florida League of Nursing, National League of Nursing, Florida Medical

Association, American Nurses Association, Society of Pediatric Nurses, National

Association of Pediatric Nurse Practitioners, the office of Governor Ron

DeSantis, and all others deemed appropriate by the FNSA Board

of Directors.
TOPIC: IN SUPPORT OF INCREASING AWARENESS ON THE LACK OF PAIN
ASSESSMENTS ON PATIENTS OF COLOR.

SUBMITTED BY: University of Central Florida Student Nurses Association

City/State: Orlando, FL

AUTHORS: Josée Sarah Etienne & Chloe Frye

WHEREAS, in health care, implicit biases function to the disadvantage of vulnerable

populations, including racial and/or ethnic minorities, immigrants, sexual
minorities, and those with disabilities (Oyeku & Raphael, 2020); and
WHEREAS, through 2013 Blacks, Hispanics, and American Indians/Alaska Natives have
continued to receive worse care for 40% of the quality measures assessed and
Asians receive worse care for 20% of measures (Maina et al., 2018); and
WHEREAS, Black patients are less likely than White patients to receive pain medication for
a wide range of painful conditions, despite reporting similar levels of pain
(Aronowitz et al., 2020); and
WHEREAS, alluding to Todd’s, Samaroo, and Hoffman (1993) seminal study of racial and
ethnic pain treatment disparities found that Latinx patients were less likely to
receive analgesia for long‐bone fracture than White patients. Nearly a decade
later, a similar study found that Black patients with acute pain from long‐bone
fractures were 66% more likely than White patients with long‐bone fractures to
receive no analgesia in the ED, despite similar expressed levels of pain (Aronowitz et
al., 2020); and
WHEREAS, Mende-Siedlecki et al. (2019), found that Black patients who were treated by
those who had a more difficult time identifying pain thresholds on black faces
were continually prescribed less non-narcotic pain reliever; and
WHEREAS, Pearson (2015), it was brought to light that many feelings reflecting racist beliefs
may be suppressed rather than resolved due to the scientific background of
medical professionals and the need to suppress potential sources of error; and
WHEREAS, Medical professionals believe that Blacks feel less pain than Whites because the
assumption is made that Blacks have a lower socioeconomic status (Druckman
et al., 2018); and
WHEREAS, the current literature reveals that implicit racial bias is present in healthcare
students as early as their first year of training (Maina et al., 2018); and
WHEREAS, transformative learning theory (TLT) is both an explanatory framework and a
guide to inform instructional design related to implicit bias. As a research tool,
TLT provides a beneficial lens through which to explore health professions
education topics that require space for critical reflection and discourse, or
experiences that are inherently discomforting (Sukhera et al., 2020); therefore
be it

RESOLVED, that the Florida Student Nurses Association (FNSA) encourages its constituent

to assess pain systematically and manage pain accordingly in patients of color;

and be it further
RESOLVED, that the FSNA encourages its constituents to educate nursing students, health care

professionals, community organizations, health care facilities, schools, and colleges

must more strongly incorporate implicit-bias training into education and

certification and implement policies that diversify the minority population; and be it

further and improving pain management in non-verbal children; and be it further

RESOLVED, that the FNSA demonstrate a commitment to health promotion by providing

education regarding methods of assessment and treatment of pain for patients

of color through seminars at State Convention each year, if feasible; and be it

further

RESOLVED, that the FNSA demonstrate a commitment to health promotion by providing

education on implicit racial bias through the process of Transformative Learning

Theory (TLT) serving as both an explanatory framework and a guide to inform

instructional design related to implicit bias; and be it further

RESOLVED, that the FNSA publish an article in Hotline on this topic, if feasible; and be it

further

RESOLVED, that the FNSA send a copy of this resolution to the Florida Nurses Association,

Florida Public Health Association, and any others deemed appropriate by the

FNSA board of directors; and be it further

RESOLVED, that the FNSA send a copy of this resolution to the National Student Nurses'

Association (NSNA) House of Delegates for considering implementing the

resolution into their policies and actions.

TOPIC: IN SUPPORT OF INCREASING USE OF TOPICAL TREATMENTS AS ADJUNCT
OR ALTERNATIVE PAIN MANAGEMENT METHOD

SUBMITTED BY: Florida Atlantic University Student Nurses Association

City/State: Boca Raton, Florida

AUTHORS: Adam Mahamad, Lauren Bordy, and Kathleen Juezan

WHEREAS, Chronic pain is a leading cause of disability in the United States. National Health
Interview Survey’s (NHIS) 2016 data shows that an estimated 50 million U.S.
adults (20.4%) experienced chronic pain. It is associated with impaired physical
mobility, opioid dependence, anxiety, depression, and poor perceived quality of
life (Dahlhamer et al., 2018, pg. 1-2). Chronic pain has profound negative
repercussions on the individual’s wellbeing. It can lead to increased morbidity
and mortality, absenteeism, unemployment, and reduced productive capacity
(Gudin et al., 2017, pg. 2); and
WHEREAS, In 2017, approximately 192 million opioid prescriptions were written in the U.S.
for pain management ("U.S. opioid prescribing rate maps”, 2020, pg. 2). Opioid
misuse and abuse is a grave national public health crisis. More than 47,000
people in the U.S. died from opioid overdose and another 1.7 million suffered
from substance use disorder related to opioid dependence. Of those patients
with opioid prescriptions for chronic pain, approximately 21-29% misuse them.
In the U.S. alone, this misuse incurs an estimated economic burden of $78.5
billion annually including the cost of healthcare, productivity loss, rehabilitation,
and criminal justice involvement ("Opioid overdose crisis", 2020, pg. 1); and
WHEREAS, One of the five major priorities designated by the U.S. Department of Health
(HHS) to help solve the opioid crisis is the promotion of better pain
management practices ("Opioid overdose crisis", 2020, pg. 2); and
WHEREAS, Topical analgesic treatment has been shown to be an effective adjunct or
alternative therapy in pain management. Topical analgesic treatment is a safe
and efficacious opioid-sparing alternative treatment approach for chronic pain
which attenuates the risk of misuse, overuse, abuse, addiction, and death
associated with opioids and other controlled substances (Gudin et al., 2017, pg.
11-12); and
WHEREAS, Use of topical analgesics in chronic pain management resulted in complete
discontinuation of opioid use in 49% of participants after 3 months and 56% of
participants after 6 months. Moreover, use of other concurrent pain
medications were reduced by 65% after 3 months and 74% after 6 months
(Gudin et al., 2018, p. 2); and
WHEREAS, Among patients who used opioids and topical analgesics concurrently, a
statistically significant reduction in overall pain severity was reported at both 3
and 6-months post-intervention, with a mean decrease of 1.9 (numeric pain
 scale of 0-10) in the treatment group as opposed to an increase of 0.2 in the
control group (placebo) at 6 months. At 6-months follow-up, participants who
used topical analgesics (intervention group) also reported a decrease in the pain
interference score of 2.2 versus a reported increase of 1.4 in the pain
interference score of the control group (Gudin et al., 2017, pg. 6).
WHEREAS, Compounded topical analgesic therapy resulted in a majority clinician report of
no adverse effects; less than 1% of participants within the intervention groups
reported a minor skin rash as the only experienced adverse effect. In
comparison, although effectual for pain relief, opioids and other pain
medications regularly cause adverse effects, including life-threatening
respiratory depression, hypotension, addiction, pruritus, nausea, constipation,
and altered level of consciousness (Gudin et al., 2017, pg. 11); and
WHEREAS, Topical analgesics are applied directly to the skin, thereby increasing local
effects and mitigating the risk of systemic adverse events (SAEs) due to lower
systemic drug concentrations (Derry et al., 2015, pg. 8); and
WHEREAS, The efficacy of topical analgesics is evidence-based. Use of topical NSAIDs to
treat acute musculoskeletal conditions has become accepted since they can
lessen pain with minimal risk of systemic adverse events. One week of topical
analgesic use in patients with acute pain (strains/sprains) yielded at least 50%
less pain in 20-50% of the participants. For those with chronic pain
(osteoarthritis), 1 in 5 to 1 in 10 participants reported pain reduction of at least
50% with topical analgesic use over 6-12 weeks. (Derry et al., 2017, pg. 5);
therefore be it

RESOLVED, that the Florida Nursing Student Association (FNSA) encourage its constituents

and members to increase awareness and advocate for the education and

training of nurses and interprofessional team-members in the utilization of

topical analgesics when caring for patients experiencing acute and chronic pain;

and be it further

RESOLVED, in support of increasing funding for further research into the efficacy, safety,

and best formulation of compounded topical pain relieving agents; and be it

further

RESOLVED, advocating for grants to subsidize the cost of topical pain relieving creams in lieu

of oral opioids, given their efficacy, better side effect profile, and fewer systemic
 adverse effects; and be it further

RESOLVED, that the FNSA publish an article in the FNSA Hotline on this topic; and be it

further

RESOLVED, that the FNSA send a copy of this resolution to Florida Nurses Association, the

Florida Medical Association, American Nurses Association, American Holistic

Nurses Association, National League of Nursing, Florida League for Nurses,

American Society for Pain Management Nursing, National Institute for Nursing

Research, and all others deemed appropriate by the FNSA Board of Directors.
TOPIC: IN SUPPORT OF THE USE OF PERSON-FIRST LANGUAGE WHEN IN REFERENCE
TO A DISABILITY OR ILLNESS ACROSS ALL SETTINGS

SUBMITTED BY: Florida Atlantic University

Boca Raton, FL
AUTHORS: Jayson Ledford, Camila Fred, Allyson Kifer, Kristin Marinas, Giovanna
Paciletti

WHEREAS, Person-first language is defined by the Washington State Developmental

Disabilities Council as a form of linguistics that reflect awareness, dignity to
person and positive attitudes about people with disabilities (2009); and
WHEREAS, The American Psychological Association (APA) advocates person-first language
in care of patients and research (2020, p. 136).; and
WHEREAS, The NSNA code of ethics states that “NSNA members understand the principle
that all nursing practice supports respect for the inherent dignity, worth, unique
attributes, cultural diversity, and human rights of all individuals”. (NSNA, 2020,
p.4); and
WHEREAS, “Person-first language: are we practicing what we preach?” in the Journal of
Multidisciplinary Healthcare mentions that “While both patient-centered and
person-centered concepts acknowledge the values, needs, and preferences of
individuals, person-centered care focuses on the person as an individual in a
holistic manner” (Crocker & Smith, 2019, p. 127).; and
WHEREAS, “The use of person-centered language in scientific research articles focusing on
alcohol use disorder” in the Drug and Alcohol Dependence journal states that “In
continuation of the shift toward reducing stigma and increasing advocacy for
the treatment of individuals with AUD [Alcohol Use Disorder], it is necessary the
sources of information that guide clinical practice adhere to PCL [Patient
Centered Language]” (Hartwell et al., 2020, 5).; and
WHEREAS, “Implementing person-centered communication in diabetes care: a new tool for
diabetes care professionals” in the Patient Preference and Adherence journal
emphasizes that “language has an impact on motivation, behaviors, and
outcomes and recommends encouraging collaborative messages for enhancing
patient engagement and empowerment. Specifically, the recommendation is for
health care providers (HCPs) to use language that is nonjudgmental, free from
stigma, respectful, and person-centered” (Connor et al., 2019, 1444).; and
therefore, be it

RESOLVED, that the Florida Nurses Student Association encourage its constituents to

advocate and raise awareness for the use of person-first language when

discussing, treating, and researching patient care; and be it further

RESOLVED, that the Florida Nurses Student Association and its constituents contact their

local hospitals to lead a call for action regarding the regular use of person first

language; and be it further

RESOLVED, that members of FNSA reach out to their local new outlets to inform and

propose the use of person-first language when referring to people with Covid-

19; and be it further

RESOLVED, that the FNSA send a copy of this resolution to the Florida Nurses

Association, the Florida Medical Association, Florida League for Nursing,

Florida Office of Minority Health and Equity, and all others deemed

appropriate by the FNSA Board of Directors.