HJNO May/Jun 2023

40 MAY / JUN 2023  I  HEALTHCARE JOURNAL OF NEW ORLEANS   Healthcare Briefs chronic diseases. In FY22, LDH completed 37 of its 42 goals (88%) and 246 of its 258 deliverables (95%) laid out in its Business Plan. “‘I’m a big believer in public service, so the opportunity to return to my home state and give back in such a meaningful way at such a critical time is something that will stay with me for the rest of my career,’ said Sec. Phillips. ‘There’s a great deal to be proud of as the head of LDH, but the intentional effort that went into equita- bly rolling out the COVID-19 vaccines and ulti- mately saving thousands of lives ranks among my top accomplishments. I want to thank Gover- nor Edwards for his leadership and all LDH team members, the Louisiana legislature and the entire healthcare system of Louisiana for their support and partnership over the past three years.’” Karen Lyon, CEO, LA State Board of Nursing Comments on Fraudulent Nursing Degrees The Department of Justice, U.S. Attorney’s Office of Southern District of Florida, recently announced, that 25 defendants were charged in a scheme to sell and obtain fraudulent nursing degrees for the purpose of obtaining a license and practicing as a nurse. Louisiana State Board of Nursing CEO/Executive Director Karen C. Lyon, PhD, MBA, APRN-CNS, NEA, stated, “As of January 27, 2023, three individuals on the FBI list have connections to Louisiana. Louisiana State Board of Nursing staff acted swiftly in respond- ing to each of these individuals and is commit- ted to safeguarding the life and health of citizens of Louisiana by assuring persons practicing as Registered Nurses and Advanced Practice Reg- istered Nurses are competent and safe.” [Pub- lished online with Healthcare Journals of Baton Rouge and New Orleans on Feb. 7] As an update, Lyon added, “Operation Night- ingale (the FBI’s name for the investigation) con- tinues, and we are provided names of nurses who may be on the affidavits provided by the fraudu- lent schools and the defendants that have been arrested by the FBI. We received another list on Friday, and we continue to vet the names of any individuals who appear on the lists who may have Louisiana licenses.” In a recent Q & A with Lyon, she provided the following answers to Healthcare Journal’s questions on the situation: Q: How many licensees were there in Louisiana? A: Only six were on the original list, and two of them were removed immediately because they were able to provide us their official documents, including legal transcripts and with documented course work. Of the four remaining, two appli- cants’ applications had expired, and they were not licensed. Of the remaining two, one never responded to our requests for documentation and that person was blocked from licensure. The remaining one did come in during the emergency COVID declaration by the Governor under the SNAP program. I do not know where the nurse practiced during the COVID emergency, but when their license came up for renewal in 2022, we did not renew them because they failed to provide us with proper documentation of licen- sure in any state. Q: How was the board informed about it? A: The FBI brought all state boards of nursing into the investigation in September 2022. At that time, they provided lists of names of nurses in all jurisdictions that appeared on the affidavits provided by the defendants in the case, includ- ing Louisiana. Q: How long had they been working in Louisiana? A: As above, only one worked here and it was dur- ing the COVID emergency. I cannot tell you how long the person worked here because the nurse came in under SNAP. Q: How many cases like this have there been in the past? A: To my knowledge, none. Q: From the board’s perspective, what should the healthcare industry know about this particu- lar situation, and what should the public know? Was damage caused? A: The responsibility for this alleged fraud rests squarely on the shoulders of the perpetrators. This was a brazen attempt to misuse nursing edu- cation programs. Nursing regulatory bodies are constantly working to ensure that all nurses and candidates are legitimate, and we are commit- ted to fully resolving this matter. This is an ongo- ing investigation and each individual is afforded due process. We cannot assume that every indi- vidual identified in the authorities’ investigations obtained illegitimate educational credentials. As with any case involving potential revocation or other action on an individual’s nursing license, we are following our state’s required processes, including appropriate due process steps. LSUHealth NO Pain Protocol Eliminates Opioids Following Knee Replacement for Most A study led by Vinod Dasa, MD, professor of orthopaedics at LSU Health New Orleans School of Medicine, reports that a novel surgical pain management strategy following total knee arthro- plasty (TKA), or total knee replacement, provided pain relief without opioids. The researchers also found that changing prescriptions for opioids at discharge from automatic to upon request dra- matically decreased opioid use. Their results are published in the Journal of Experimental Orthopaedics . “About 70% of opioid-naïve patients needed only Tylenol and anti-inflammatory medications to manage their pain,” said Dasa. “Opioid use in healthcare is improving but remains difficult to manage. Surgical pain was long thought to be unavoidable, requiring a large amount of pain medications. Creating innovative strategies to enhance surgical recovery by reducing pain and eliminating opioids can help solve some of our biggest challenges.” The 144 patients in the retrospective study received the same multimodal analgesia protocol except for postoperative opioid prescribing. The novel multimodal analgesia regimen included percutaneous cryo-neurolysis, a long-acting nerve block, about five days before surgery. Immedi- ately before surgery, patients received a single dose of 150mg pregabalin, 200mg celecoxib, and 1000mg intravenous (IV) acetaminophen. Upon discharge, all patients were advised to take 325mg of acetaminophen every four hours for two weeks and 75mg of diclofenac every 12hours for 6weeks. The authors conclude, “More than half of all TKA patients and 72% of opioid-naïve patients who were treated with a multimodal pain pro- tocol designed to minimize opioid use for up to threemonths, and received opioids only upon request after surgery, recovered from TKA with- out the use of any opioids and any worsening of self-reported pain or knee-related problems