The 2008 National Educational Conference Recordings!

New for 2008! AALNC is pleased to offer online and on-demand access to the 2008 National Educational Conference Sessions. These sessions have been recorded, fully synchronized to PowerPoint presentations, and are now available for year-round access. By purchasing access, you will receive the following for each conference session:

This workshop will explore the principles and practices that will help you get started in the profession. Experienced LNCs will discuss lawsuite processes, research, practice areas, medical record review and business principles.

Giving expert testimony, whether at a deposition or at trial, can be a challenging experience. Testifying effectively involves characteristics and skills that are very specific. The purpose of this workshop is to highlight the requisites that characterize best practices of the most effective testifying experts. The topics presented are divided into three categories: preparation before testifying, behaviors during testimony and responsibilities after testimony. A few of the aresa discussed in detail include: document review, defining the issues ofthe case, working with the attorney, interacting with the judge and jury, how to respond to loaded questions, anticipating testifying pitfalls and professional demeanor when under pressure. Familiarity with the topics presnted will enable the legal nurse consultant to be a more effective and confident witness.

This workshop will summarize a number of actual lawsuits from the speaker's own experience with telehealth litigation. Emphasis will be placed on red flags and lessons learned. Among these cases will be a number of unfavorable outcomes that could possibly have been prevented by adherence to standards, recognition of life-threatening emergencies, improved communication with the provider and the other critical elements of care.

Case law is passing in various states on entering bills into medical evidence. Combined with determinations and appropriate methodologies in pricing your life care plan, today's LNC must be ready to address both reimbursement issues as well as making usual and customary determinations. This workshop will address these issues for consideration along with pitfalls to avoid in order to become a successful life care planner.

Pre-Conference #104
Joint Commission Update for Legal Nurse Consultants
Susan Mellott, PhD RN CPHQ FNAHQ CLNC
(Optional - Ticket Required)

The LNC works with medical records and healthcare facilities in reviewing cases for the attorney. It is important for the LNC to understand how the Joint Commission is changing and what this means for the healthcare facilities that it accredits. This workshop will enable the LNC to better understand the current processes utilized by the healthcare facilities to meet these standards. The speaker will help the LNC to identify the processes within the healthcare facility that may be useful to the case being reviewed. The LNC then will be ready for the planned changes that the Joint Commission is currently developing.

James Riley was first condemned to death during the early 1980s when racial tensions in Dover were common. At the time, Delaware's sole method of execution was by hanging. After years of unsuccessful appeals and a landmark ruling by the Superme Court, Mr. Riley wona new trial when the court ruled that the prosecution had imporperly excluded African-Americans from the jury. During the second trial, Mr. Riley represented himself with assistance of stand-by counsel. He was acquitted of intentional murder but still faced the death penalty for felony-murder. Mr. Riley's counsel, with the assistance of a forensic psychologist, was able to spare his client a death sentence by a thorough review of more than 30 boxes of investigative materials and 25 years of prison records demonstrating his client's chnging mental health status and the phenomena of "aging out." Mr. Gabay will explain the importance of a global review of a defendant's life and history in preparing a mitigation case and explain how "bad" evidence may actually be good for the client. Additionally, he will discuss the effects of culture on a criminal tiral and participants will learn the importance of changing mental status and the "aging out" phenomenon.

Pre-Conference #106
"Your Image is YOU" - Successful Image and Marketing Creation 
Jacqueline Chiudioni, RN
(Optional - Ticket Required)

Your communication skills and the image you present create the first impression - often the lasting impression- on the people you meet. Creating a successful image strategy involves coordinating all of the elements of your marketing message ot achieve a consistent, memorable impression. This workshop will analyze the essential elements necessary to create a successful business image.

Opening Keynote #200
The Phoenix Factor: Transforming Life's Challenges into the Foundation for Future Success
John O'Leary, Professional Speaker and Author

The phoenix is one of the most celebrated creatures in world mythology. As it senses its own death approaching, this great bird builds a nest, lies in it, ignites it and burns itself to ashes. From these ashes it rises, soaring even higher, beginning another cycle of life. As the result of a childhood fire, John O'Leary was burned as completely as a person could be without dying. However, John survived the fire and in many ways feels as if he were reborn into another existence. Such can be the nature of our disasters, if we permit ourselves to accept what happened, learn its lessons and resolve to take flight into new life. The Phoenix Factor proposes not that we can avoid tough times, but that each of us can grow from them, change our direction, rise to new heights and soar in life.

Concurrent Session #201 
Orthopedic Complications
Sharon Rennick, RN BSN CLNC

Ms. Rennick will present case studies of multiple orthopedic complications and discuss how they relate to medical malpractice cases from an expert witness point of view. Participants will learn the important symptoms related to Cauda Equina Syndrome and recognize documentation that is significant to changes in patient status and is related to orthopedic complications.

Concurrent Session #202 
Risk Management View of Disclosure - A Must
Cheryl Long, RN CPHRM

Disclosure of adverse events and appropriate documentation of the disclosure is needed to provide patients the information required to plan for healthcare. The Join Commission now requires accredited facilities to have a process in place for the disclosure of unanticipated outcomes. Physicians and healthcare providers daily disclose information about diagnoses, prognoses or complications of anticipated complications; however, there is a hesitancy regarding disclosure of adverse events based on fear of malpractice claims. Many healthcare providers who believe in the honesty of disclosure nonetheless are unsure how to proceed and where to document the disclosure. The speaker will explain the what, why, when and how of disclosure and its impact on patient safety.

Concurrent Session #203 
Secrets from the Trenches
Dolly Curley, RN BS BSN DABFN LNCC
Ilene Warner-Maron, RND CWCN MA MLSP CALA NHA PhD (ABD)

This highly interactive session uses the extensive experiences of both a consultant and an expert in the field of legal nurse consulting to demonstrate the techniques necessary for success. The experiences of the speakers, which cannot be found in a textbook or journal, will enhance the skills of the participants. The speakers will provide illustrations to the salient points relative to investigation, analysis, research, financial implications and legal principles. Also, two case studies will be discussed.

Power Lunch Session #210 
My Reality: A Self-discovery Matrix
Beryl Byles, Executive Coach/Leadership and Management Consultant
(Optional - Ticket Required)

This program will describe and demonstrate the rationale, the specific process and the benefits of using the discipline of the self-discovery process to make choices, both personal as well as professional, that uniquely reflect an individual's strengths, preferences and values. It will help to adjust the reality of the expression, "My insides want what your outsides look like." The takeaway will be a sample matrix to serve as a model for individual use toward the goal of achieving clarity and energy as a result of the discipline of this evaluation process.

Concurrent Session #220 
Developing an "Eye" for an Eye Case
Joel Confino, MD

Even experienced trial lawyers, consultants and reviewers of medical-legal matters have difficulty interpreting, comprehending and evaluating medical records and issues related to eye care and potential litigation. Ophthalmology has its own language, format and unique variables as related to legal consulting. Dr. Confino, an experienced ophthalmologist/surgeon/medical-legal consultant, will explain how to understand and interpret eye care medical records and terminology, discuss issues of damages and liability unique to eye care matters and cite several examples of cases involving some of the common areas of litigation, such as cataract surgery, laser vision correction, traumatic injuries and others.

Concurrent Session #221 
From Hospital to Courtroom - Managing a Premier Legal Nurse Consulting Practice for 20 Years
Jenny Beerman, RN BS MN

This session will begin with an overview of what it takes to grow and maintain a very successful nurse consultant and expert witness practice for 20 years. It will include the need for current practice, professional writing, networking, organization and client referral. Ms. Beerman will then present two case studies, including both the plaintiff and expert perspectives. Medical records and trial testomony will give insight on this topic to the most experienced LNC.

Concurrent Session #332 
Healthcare Fraud in the Emerging eHealth World
Rebecca Busch, RN MBA CCM CFE FHFMA

This session will discuss emerging themes for an LNC to be aware of in an eHealth world. Topics will include how fraud and abuse materialize in health records in the provider setting, payer setting and employer setting. Ms. Busch will discuss an overview of fraud and abuse and how to look for it, and will define practical applications of fraud and abuse in its detection.

Concurrent Session #230 
The Acute Abdomen: When Emergency Department & General Surgeons Come to Blows
L. Peter Fielding, MD FRCS FACS

The "golden hour" to achieve maximum benefit for trauma victims is well recognized. Similarly, the "door to cath-lab time" is an important measure of service quality for pateients with suspected myocardial infarction. The pathophysiology ofr the great majority of patients with an "acute abdomen" is the same or similar to these two examples. The speaker will discuss the importance of patient history and physical exams as the basis of surgical referral decisions. Learn what Dr. Fielding believes could increase the quality of patient care, reduce complications, imporve results and greatly diminish the opportunity for medical malspractice litigation.

Concurrent Session #231 
Expert Witness Testimony: Clips and Tips
Kathleen Ashton, PhD APRN BC

Using an interactive format with actual videotaped deposition testimony, the speakers will engage the audience in discovering some useful ways to deliver testimony and avoid common pitfalls. In addition to viewing the video clip, participants will be guided through a critique of the testimony and will be challenged to develop alternate strategies for handling various types of opposition. Geared to the advanced practitioner, this session will offer useful tips for LNCs at all levels.

Concurrent Session #240 
Untangling Anesthesia Issues
Deborah Dlugose, RN CCRN CRNA

The dynamic nature of rapidly moving anesthesia and surgical events, patient variability, and a broad spectrum of medications, techniques and monitoring create an environment with complex challenges for case analysis. Case review may focus on whether anesthesia providers anticipated difficulty at the time of assessment and planning. However, potential for unexpected events is always present, leaving anesthesia providers in a reactive position. The speaker will discuss how factors such as economic production pressure and patients with increasingly complex health issues bring increased risk to the table. The Anesthesia Care Team (usually Anesthesiologist and CRNA) is the most common model of care, requiring that responsibility for decision-making and actions be delineated. Learn about the inherent risks associated with anesthesia care. Ms. Dlugose will sort out these complicated strands from case documents, including the often-cryptic anesthesia record, which requires careful analysis.

Concurrent Session #232
The Trifecta of a Medical Malpractice Case - Part 1
Rose Clifford, RN LNCC
Karen Krooswyk, MSN RN
Sandra Sprugeon, JD

Part 1 of 2: This session focuses on the dual roles of the independently practicing LNC and how nurses assisted the attorney to achieve a successful outcome for the plaintiff's family. The session will be centered on an actual case in which the attorney utilized both a cosulting expert and a testifying expert. This case will be presented first by the attorney, then the consulting expert will speak on her role and how the initial medical chronology was completed.

Concurrent Session #241 
Rompilla v. Beard: New Opportunities for the Legal Nurse Consultant
Brenda Ewen, MSN RN D-ABMDI CFC
Joseph A. Gabay, Esq.

In Rompilla v. Beard the Supreme Court expanded the duty of the defense to investigate a capital defendant's background at both trial and on post-conviction review. It is no longer sufficient to present anecdotal evidence about school or behavioral problems or abusive childhoods. Capital case mitigation preparation now requires investigation into healthcare issues which may cause cognitive deficits such as prenatal care, prenatal substance abuse and exposure to circumstances and substances affecting brain development or damage. Psycho-forensic evidence is critical in the case for life. Knowledge of legal and healthcare systems and expertise in interview and documentation skills allow the LNC to assist in the thorough development of the mitigation case. LNCs can provide attorneys with the knowledge and skills, as well as the critical record analysis, to translate those records into words and exhibits that will resonate with a jury.

Concurrent Session #242 
The Trifecta of a Medical Malpractice Case - Part 2
Rose Clifford, RN LNCC
Karen Krooswyk, MSN RN
Sandra Sprugeon, JD

Part 2 of 2: This session focuses on the dual roles of the independent practicing LNC and how nurses assisted the attorney to achieve a successful outcome for the plaintiff's family. The session will be centered on an actual case in which the attorney utilized both a consulting expert and a testifying expert. Part 2 will focus on the role of the nursing expert through the deposition phase and how this role interfaced with the consulting expert role. Ms. Krooswyk will speak to various aspects of the case and how issues were resolved prior to the deposition being taken. She also will speak to some of the issues that occurred with the defense nursing experts during their depositions and how the case concluded.

Concurrent Session #401
Role of the Legal Nurse Consultant in Correctional Healthcare Litigation
Joseph Paris, PhD MD CCHP Fellow of the SCP

The LNC has much to offer in the field of correctional healthcare litigation. However, basic principles must be understood, such as the difference between civil rights (deliberate indifference) and malpractice suits, prison or jail, NCCHC or CA standards and the unique documentation in use in correctional healthcare. Dr. Paris will share his field experience of over 75 correctional healthcare cases for either the plaintiff or the defense and will highlight the various litigation phases, including discovery, preparation of summaries, depositions and trial appearances.

Concurrent Session #301
Gadolinium-based Contrast Agents: Liability Overview
Karen Kahle, BS JD

The Food and Drug Administration (FDA) has issued several alerts in recent years requesting that manufacturers of Gadolinium-based contrast agents include certain warnings in the drug's labeling, primarily related to the development of nephrogenic systemic fibrosis in a narrow category of patients. This session will examine this class of drugs, the history and substance of the FDA alerts and how FDA actions such as this impact potential liability in tort actions. Likely defenses to such tort actions and the likely injury claims also will be discussed.

Concurrent Session #302 
Pressure Ulcers: Prevention, Treatment and the Nutrition Connection
Martie Hawkins, RN BSN CWOCN CCM
Janet McKee, MS RD LD

Every pressure ulcer is unique and various articles, wound care books, textbooks and medical supply companies present many different treatment options for pressure ulcers. Therefore, it is essential to become familiar with the literature and best practices that are supported by evidence-based research which validates different prevention and treatment options. The speakers will discuss the causes of pressure ulcers in elderly adults and best practices in the prevention and treatment of pressure ulcers. Also, discussion will include the new changes to the staging definitions of pressure ulcers and the various treatment options for those stages, avoidable versus unavoidable pressure ulcers and the role of nutrition in the treatment of pressure ulcers. The speakers will identify the preventive and treatment measures for pressure ulcers that nursing nutrition experts use in defending or making a claim against a long term care facility. The importance of appropriate and timely documentation in defending against, or making, a pressure ulcer claim will also be discussed.

Concurrent Session #313 
LNCC® Certification Workshop
ALNCCB Members

Ask members of the American Legal Nurse Consultant Certification Board (ALNCCB) any questions you may have regarding the LNCC exam or recertification process.

Concurrent Session #320 
Understanding the Importance of the Multidisciplinary Approach to the Mangement of Spinal Cord Injuries
Cathy B. Thomson, MD
Billie Sillis, RN MSN ARNP

Spinal cord injuries are one of the most clinically complex situations that face members of the healthcare team. From the onset of injury, acute care, rehabilitation and reintroduction to everyday living, the journey is full of challenges, setbacks and more challenges, not only for the patient, but also for the physicians, nurses, therapists and family that make that journey with the individual. The speakers will review the anatomy, physiology, appropriate diagnostic testing for spinal cord injuries, the role of the nurse caring for this type of patient throughout the acute and rehabilitation phase and various problems and potential problems the patient may experience and the role of the LNC in evaluating the standard of nursing care the individual has a right to expect.

Concurrent Session #322 
Colleagues on Opposite Sides of the Fence
Kathleen Colfer, MSN RN BC
Elisabeth Ridgely, BSN RN LNCC

This session will be given by opposing expert witnesses on a medical malpractice case. There will be a brief description of the facts of the case and then each expert will discuss the development of her opinions. After reporting the outcome of the case the experts will discuss issues that may arise when colleagues and friends are on opposing sides of the same case.

Concurrent Session #324 (Repeat) 
Orthopedic Complications
Sharon Rennick, RN BSN CLNC

Ms. Rennick will present case studies of multiple orthopedic complications and discuss how they relate to medical malpractice cases from an expert witness point of view. Participants will learn the important symptoms related to Cauda Equina Syndrome and recognize documentation that is significant to changes in patient status and is related to orthopedic complications.

Concurrent Session #330 
Pharmaceutical Litigation Discovery and How Its Lessons Can Be Applied to Other Litigation
Russell Thornton, JD

Mr. Thornton will address key elements of discovery in pharmaceutical cases and the importance of evidence obtained from these sources for the three parties generally involved in pharmaceutical cases: claimants, manufacturers and prescribing physicians. In addition, Mr. Thornton will discuss how discovery resources commonly utilized in pharmaceutical litigation can provide important evidence for use in any personal injury claim.

Concurrent Session #331 
The Use of Evidence-based Clinical Practice within the Role of the Legal Nurse Consultant
Daniel Berman, RN MSN PsyD CPHQ

This session will discuss how the use of evidence-based practice and accepted National Standards of Care can be incoprorated in the practice of Legal Nurse Consulting. Participants will learn how to research and delineate evidence-based practice based on the medical discipline in question and present salient points related to the research to the attorney.

Concurrent Session #222 
Undermanagement of Pain in the Elderly
Margaret Wacker, RN BSN MS MA PhD

Undermanagement of pain in the elderly, particularly in long term care facilities, has reached public health reportable proportions. Understaffing and significant knowledge deficits in professional and assistive personnel are two key elements in this scenario. The speaker will discuss the negligent undermangement of pain and the morbidity of mismanagement of pain in an elderly population. Ms. Wacker will present case studies from her experience as a plaintiff expert witness and help attendees recognize the early signs of negligence in chart reviews.

Concurrent Session #340 
Liability Issues in OB/Neonatal Nursing
Camille DiCostanzo, RNC MS NNP

This session will inlcude an overview of hot topics in OB and neonatal nursing. Additionally, it will include areas of risk and strategies to mitigate these risks; specifically neonatal resuscitation, vaccuum extraction, Pitocin pitfalls, Hyperbilirubinemia and Kernicterus.

Concurrent Session #341 
Elder Abuse: Assessment and Litigation
Mitzi Wortman, RN

Ms. Wortman will review the legal documents associated with elder abuse issues and discuss how to identify signs of elder abuse and understand the purpose for restraining orders. This session will include definitions of financial, physical and emotional abuse. Additionally, the speaker will provide an outline on how to proceed in litigation involving elder abuse.

Concurrent Session #342 
Pitfalls for the Nurse Expert
Rebecca Cady, RNC BSN JD

Today's nurse expert is faced with potential pitfalls in expert practice. These pitfalls include issues related to qualifications, billing and records, preparation and testimony, as well as ethical and potential repercussions. When the expert does not avoid these it can impact the expert's practice and license. This session will identify the specific pitfalls facing the nurse expert, the consequences of failing to avoid them and will discuss ways in which the nurse expert can avoid them.

Concurrent Session #350 
Expedition for the Legal Nurse Consultant: Maps to Guide Your Internet Search
Kara DiCecco, MSN RN LNCC

Just as the stethoscope is an essential tool in nursing, the Internet is an essential tool in your LNC practice. With all the information available on the Web, LNCs who have the ability to locate and look into credible sources quickly, efficiently and in a cost-effective manner are undeniably respected and highly marketable. Regardless of your practice setting, independent or in-house/expert or consultant, the dynamic medical-legal environment requires the LNC to continuously adapt, optimize and organize their database of resources. Whether you are looking fo the secrets to medical-legal research, pearls of wisdom only the medical residents know, how to find reliable standards of care, the mysteries of "cybersleuthing" or just want to find that great website again, this fun and interactive session is for you!

Concurrent Session #351 
Life Care Planning and End of Life Issues
Valerie Parisi, RN CRRN CLCP

This session will address the use of life care planning in cases of oncology and other terminal illnesses such as HIV/AIDS or end stage diseases such as renal disease or cardiac failure. The speaker will demonstrate why a life care plan is essential in these cases to promote quality of life, even as life expectancy is significantly diminished. It can also help all interested parties understand the needs of those clients who are facing a terminal illness for the purpose not only of education, but also the consideration of medically appropriate and compassionate medical care when considering damages in these cases.

Concurrent Session #352 
Oh, The Places You'll Go: Taking Your Legal Nurse Consultant Career in New Directions
Melanie Osley, RN BS BSN MBA CPHRM DFASHRM

"Oh, the Places You'll Go" will increase the awareness of opportunities for the LNC that expand into the field of healthcare regulatory affairs. Today's promulgation of requirements with which healthcare entities must comply requires LNCs to interpret the overlapping disciplines of risk, quality, compliance, patient safety and patient satisfaction.

Concurrent Session #400
Preventing Abusive Head Injuries through Hospital-based Parent Education: The Pennsylvania Shaken Baby Syndrome Prevention and Awareness Program
Kelly Cappos, RN BSN CPUR CLNC
Carroll Rottmund, RN BSN CCRN CLNC

The speakers, two Pennsylvania Nurse Coordinators for the Shaken Baby Syndrome Prevention and Awareness Program, will address the history, incidence, cause, risk factors, signs and symptoms, diagnosis, treatment, consequences and most importantly, recommendations for the prevention of infant abusive head inuries, including shaken baby synmdrome. SBS program implemenation, roadblocks, investigation techniques, legal implications, common legal defenses, and documentation requirements for compliance to PA Act 2002-276, The Pennsylvania Shaken Baby Syndrome Education Act, will be discussed.

Concurrent Session #300
Surviving Sepsis
Sandra Bogenrief, RN BSN CLNC

Unfortunately, confusion between infection and sepsis is responsible for delays in identifying sepsis. This delay can and often does result in tragic outcomes. There are better defined standards in this area now being encouraged. Sepsis is found in every venue of nursing. Ms. Bogenrief will examine what we must know to understand, identify and treat sepsis. In addition, she will describe the five symptoms of Systemic Inflammatory Response Syndrome (SIRS) and explain the key differences between SIRS Sepsis, Severe Sepsis, and Septic Shock. This knowledge will help an LNC to better evaluate whether standards of care were followed.

Concurrent Session #402
Deposition and Trial Testimony: The Good, the Bad and the Ugly - Part 1
Patricia Calhoun, ASN BA JD
Suzanne Collins, PhD JD MPH
Daneil McAuliffe, LHCRM BSN JD
Cynthia Mikos, BSN MBA JD

Part 1 of 2: Members of the Tampa Chapter of the American Association of Nurse Attorneys will provide a panel session on preparing and testifying at depositions and trials as a fact witness, defendant or expert. The session will include mock testimony of a nurse at deposition and trial. Also, the panelists will discuss the special concerns applicable to licensed individuals such as nurses and the risk of licensure complaints and criminal charges associated with adverse incidents, alleged malpractice and testimony.

As long term care cases continue to gain in popularity in the legal arena the legal nurse consultant is increasingly more valuable in investigating, evaluating and preparing cases for trial. A current in-house legal nurse consultant team and an experienced long term care trial attorney will present current trends in the nursing home and assisted living industry and the process of how they prepare and defend these long term care cases.

Concurrent Session #411
Deposition and Trial Testimony: The Good, the Bad and the Ugly - Part 2
Patricia Calhoun, ASN BA JD
Suzanne Collins, PhD JD MPH
Daneil McAuliffe, LHCRM BSN JD
Cynthia Mikos, BSN MBA JD

Part 2 of 2: Members of the Tampa Chapter of the American Association of Nurse Attorneys will provide a panel session on preparing for and testifying at depositions and trials as a fact witness, defendant or expert. The session will include mock testimony of a nurse at deposition and trial. Also, the panelists will discuss the special concerns applicable to licensed individuals such as nurses and the risk of licensure complaints and criminal charges associated with adverse incidents, alleged malpractice and testimony.

Concurrent Session #412
Forensics and the Link to Violence, Trauma and Injury
Ellen Plummer, DL MJ RN BSN CCRN

The relationships between violence, traumatic injury and the healthcare environment are recognized as significant problems throughout the world. Interpersonal violence is identified as a serious publich health concern, yet profound deficits exist in the healthcare environment to deal with this epidemic. Road traffic injuries alone are on the rise and are becoming a leading cause of the global disease burden. This two-part session will emphasize the differences between blunt and penetrating trauma using the principles of physics and forensics in the analysis of clinical injuries. Part 1 will address violence and intentional injury, ballistics, wound identification and the importance of forensic evidence collection and preservation. Part 2 will address non-intentional inuries, crash and fall dynamics, missed injuries and the use of forensics in identifying blunt traumatic injuries and in evidence collection. Short case studies will be threaded throughout each session.