7
The Nursing Institute presents Dimensions in Cardiac Care 2012 September 23 – 25, 2012 InterContinental Hotel & Bank of America Conference Cleveland, Ohio www.clevelandclinic.org/cardiaccare

The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

  • Upload
    others

  • View
    1

  • Download
    0

Embed Size (px)

Citation preview

Page 1: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

The Nursing Institute presents

Dimensions in Cardiac Care 2012

September 23 – 25, 2012InterContinental Hotel & Bank of America ConferenceCleveland, Ohio

www.clevelandclinic.org/cardiaccare

Page 2: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

Dimensions in Cardiac Care

2012

Overview

Cleveland Clinic Nursing Institute is hosting the 30th annual Dimensions in Cardiac Care 2012 conference designed to provide the nursing professional with the latest trends in cardiac care. This three day conference includes topics on interventional cardiology, cardiovascular medicine, cardiovascular sur-gery, thoracic surgery, transplantation, and mechanical assist devices.

Objectives

1. Discuss indications for current medical, surgical, and pharmacological interventions in the care of the cardiovascular patient.

2. Describe innovative strategies in the management of heart failure in the current health care environment.

3. Describe the outcomes of an interdisciplinary team approach in the management of cardiovascular, thoracic, and transplant patient populations.

4. Describe alterations in assessment parameters associated with various cardiovascular diseases.

5. Identify challenges in the care of patients

on the transplantation continuum.

Abstract Submission Guidelines

You are invited to submit an abstract of on-going cardiac, thoracic, vascular or critical care nursing research or projects for consideration in the poster session. Non-research posters should address clinical projects, novel programs or a solution to meet the needs of cardiac, thoracic, vascular, or critical care patients, families or the teams who care for these patients.

Deadline

Abstract submission must be received no later than August 13, 2012. You will be �������of acceptance by August 27, 2012 via e-mail. Abstracts must be submitted by e-mail to [email protected].

Submission Instructions

Abstracts not conforming to the stated requirements will not be reviewed and will be returned to sender.

�� ������� ������������������ ������������������������ �������������

Black type using a 12 pt font size and 1” margins.

Do not include charts or graphs.

Research abstracts must include: problem statement, aims, methods������������� �����������!�����������������!���������"����� ������results, and implications for nursing. Bold type the title of each section.

Non-research abstracts must include: background/problem, project description, project goals, evaluation/results and implications for nursing. Bold type the title of each section.

#�����$�������"��������� �������������� �������"��������%&�����"���������$�����"���������������������������'(������������ ���������������������������("��������������)$$�������(�"�������������������������$����������������"�����������*������������������"��������������"�����������������+$�������������������#��������������������$����� ��(������������$���%/+3�*4556+489�;'+54')�/'846��<�����<��;$����/��4�(9��������8��!������+9�*��!����������������=�>������������� ���"�?����������������������

4������ �!�������$���� �$���(������!� ��(������ �����%'�������������� name, address, telephone number; primary author’s credentials and professional�"��������F��������G�(���"������ �(��������$������������� �� ���� ������� ����!��������$�������������

Poster PresentationsIf your abstract is accepted, please note the following:

5������������$���������HJ�KJ������5����� ����HJ�(KJ����������L��

No tables will be available for tabletop poster displays.

A panel of nurse researchers and practitioners will review submissions.

'�����$��(������������ ��!��MO������� ����"�����"���8��"���� ���������������M�����"������?��(�������������

Accreditation'���������$������������!���(���4$��� ��4��� �������"8���� ��?8���/������448/�"��PO���8���� �9�����;(����(8�658���������4�>�Q8�#�����$������POROK�

Page 3: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

Conference Co-Directors Myra Cook, MSN, RN, ACNS-BC, CCRNClinical Nurse Specialist, Cardiovascular ICUHeart & Vascular Institute

Deborah Klein, MSN, RN, APRN-BC, CCRN, FAHAClinical Nurse Specialist, Coronary ICU, Heart Failure ICU and Cardiac Short Stay/PACU/CARUHeart & Vascular Institute

Deborah Brosovich, MA, RN, CCRNAssistant Director of NursingHeart & Vascular Institute

Rosslyn VanDenBossche, BSN, RNAssistant Director of Nursing Heart & Vascular Institute

Guest Faculty

Dae Capobianco, CCDS, CEPSMedtronic, IncIndependence, Ohio

Marilena DiSilvio, RN, JD Remington Co, LPACleveland, Ohio

Karen Donatello, RN, RCIS, CCDSMedtronic IncIndependence, Ohio

Kathryn Roberts, MSN, RN, CNS, CCNS, CCRNPresident, American Association of Critical-Care NursesThe Children’s Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Brian Tilton, RCIS, CEPSSt. Jude MedicalSt. Paul, Minnesota

Nancy Albert, PhD, RN, CCNS, CHFN, CCRN, FAHA, FCCM

Nancy Bair, MSN, RN, CNS-BC John Bartholomew, MDCheryl Bell, BSN, RNHolli Blazey, MSN, RN, ANP-BCKenneth Bober, BSN, RN, CCRNMarie Budev, MDTheresa Cary, MSN, RN, ACNS-BC, CCRNJennifer Colwill, MSN, RN, PCCN, CCNSMyra Cook, MSN, RN, ACNS-BC, CCRNBonnie Deran, BSN, RNJeanette Drake, MSN, RN, ACNPEmily Ferrall, MSN, RN, FNP-BC Natalie Ferris-Barbastefano, MSN, RN, ACNPJodie Fink, PharmD, RPh, BCPSJanet Fuchs, MSN, RN, MBA, NEA-BC Marc Gillinov, MD Kenneth Gorski, RN, RCIS, RCSA Katherine Greenlee, PharmD, RPh, BCPSChristinna Haire, MSN, RN, CCRN, CCTCKathleen Hill, MSN, RN, CCNSDavid Holloway, MSN, RN, ACNP, CCRN, CFRN

Kathy Isaacson, BSN, RNSamir Kapadia, MD Lisa Keene, RN Deborah Klein, MSN, RN, APRN-BC, CCRN, FAHAAmy Kroen, BSN, RNSean Lyden, MD Sandy Maag, BSN, RNTara Mastracci, MDKelly Melgun, BSN, RNVenugopal Menon, MD, FAHA, FACCJosalyn Meyer, BSN, RN Mary Beth Modic, MSN, RN, CNS, CDEMaria Mountis, DOSteven Nissen, MD, MACCCheryl O’Brien, BSN, RN, JDJoseph Parambil, MDPatrick Parete, BSN, RN, CNOR, RNFADonna Patno, DNP, RN, CNM Shannon Pengel, MSN, RNMeghan Pishnery, BSN, RN, CCRNLouis Pitschmann, MSSA, LISW-SLeopoldo Pozuelo, MD, FACP, FAPMSiva Raja, MD

Daniel Raymond, MDFrank Rigelisky, PharmD, RPh, BCPS Jill Ronyak, BSN, RNGeorge Rouse, BSN, RN James Rozelle, RN, EMT-P Joseph Sabik, MD Sandra Seidlecki, PhD, RN, CNSChristina Shane, MSN, RN, AOCNSLeslie Simko, BSN, MS, RNNicholas Smedira, MDMartin Smith, STD Marian Soat, MSN, RN, CCNS, CCRNJacqueline Spence, MSN, RNKatie Stabi, PharmD, RPh, BCPSLars Svensson, MD, PhDMichelle Sweat, BSN, RN Marsha Thompson, MSN, RN, FNP-BCKathleen Tripepi-Bova, MSN, RN, CCNSMarjorie Urban, MSN, RN Cathie Vacha, MSN, RN, ACNPDana Wade, MSN, RN, CNS-BC, CPHQMonica Weber, MSN, RN, CNS-BC, CIC, FAHAMarianela (Nelita) Zytkowski, DNP, RN-BC, NEA-BC

Cleveland Clinic Faculty

Page 4: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

7:00 AM REGISTRATION / CONTINENTAL BREAKFAST

7:45 AM WELCOME & ANNOUNCEMENTS

8:00 AM

8:30 AM

9:30 AM BREAK / EXHIBITORS

10:00 AM

11:00 AM

11:50 AM BREAK / EXHIBITORS

1:00 PM

2:15 PM

3:15 PM BREAK / EXHIBITORS

3:30 PM

4:30 PM BREAK / EXHIBITORS

5:00 PM

6:30 PM ADJOURN

Dimensions in Cardiac Care 2012AGENDA

TRACK 1 12 Lead ECG Interpretation TRACK 2 Electrophysiology / Cardiovascular Lab

TRACK 3 Advanced Practice Nursing Pharmacology

Heart Dissection LabBrian Tilton, RCIS, CEPS

Intravenous AcetaminophenKatie Stabi, PharmD, RPh BCPS

Cardiac Medication Update 2012David Holloway, MSN, RN, CCRN, CFRN

Overview of Cardiac Assist DevicesLisa Keene, RN Patrick Parete, BSN, RN, CNOR, RNFA

Prescribing and Schedule II UpdatesJanet Fuchs, MSN, RN, MBA, NEA-BC

Radiofrequency AblationKelly Melgun, BSN, RNCheryl Bell, BSN, RN

Postoperative Pain ManagementNatalie Ferris-Barbastefano, MSN, RN, ACNP

Bundle Branch Blocks Wide Complex TachycardiasDeborah Klein, MSN, RN, APRN-BC, CCRN, FAHATheresa Cary, MSN, RN, ACNS-BC, CCRN

Hybrid Procedures in the Cardiovascular Lab:Transcatheter Aortic Valve Replacements Michelle Sweat, BSN, RN

Case Based Heart Failure InterventionsJodie Fink, PharmD, RPh, BCPS

Door to Balloon Time: Overcoming BarriersJames Rozelle, RN, EMT-P

Joint National Committee 8 Lipid Guidelines UpdateFrank Rigelisky, PharmD, RPh, BCPS

Putting it All TogetherDeborah Klein, MSN, RN, APRN-BC, CCRN, FAHATheresa Cary, MSN, RN, ACNS-BC, CCRN

Vascular Closure DevicesKenneth Gorski, RN, RCIS, RCSA

Joint National Committee 8 Hypertension Guidelines UpdateKatherine Greenlee, PharmD, RPh, BCPS

Session 4) EVENING PANEL Heart Failure Readmissions: An Interdisciplinary Approach to Patient and Family Education

Josalyn Meyer, BSN, RN George Rouse, BSN, RN Theresa Cary, MSN, RN, ACNS-BC, CCRN Emily Ferrall, MSN, RN, FNP-BC Jodie Fink, PharmD, RPh, BCPS

Sunday, September 23, 2012

Monday, September 24, 2012

7:00 - 7:45 AM REGISTRATION / CONTINENTAL BREAKFAST

7:45 - 8:00 AM WELCOME & ANNOUNCEMENTS 8:00 - 8:50 AM Session 5) The Future of Cardiac Surgery: Quality and Safety Initiatives Nicholas Smedira, MD

8:50 - 9:40 AM Session 6) AACN President’s Theme: Dare To Kathryn Roberts, MSN, RN, CNS, CCNS, CCRN 9:40 - 10:30 AM BREAK / EXHIBITORS

10:30 - 11:30 AM Session 7) Aortic Aneurysm Interventions and Nursing Considerations Marian Soat, MSN, RN, CCNS, CCRN

Session 8) Is the Way We’ve Always Done It the Way to Always Do It? Kathleen Hill, MSN, RN, CCNS Session 9) Chest X-ray Interpretation: The Basics and Beyond Jeanette Drake, MSN, RN, ACNP

Session 10) Innovations in Heart Valve Replacement Samir Kapadia, MD Session 11) Eliminating Codes Outside of the ICU: Is this Possible? Shannon Pengel, MSN, RN

11:30 AM – 12:50 PM LUNCH / EXHIBITORS

12:50 - 1:50 PM Session 12) Management of Venous Thromboembolism

John Bartholomew, MD

Session 13) Understanding New and Updated Performance Measures in Heart Failure: What Does it Mean to Nursing Practice and Patient Care?

Nancy Albert, PhD, RN, CCNS, CHFN, CCRN, FAHA, FCCM

Session 14) Diabetes and Heart Disease: Glycemic Control Mary Beth Modic, MSN, RN, CNS, CDE

Session 15) Medical and Psychosocial Challenges of the Heart Transplant Recipient

Christinna Haire, MSN, RN, CCRN, CCTC Jill Ronyak, BSN, RN

Session 16) Becoming a Certified Nurse: Is it Good for Me? Is it Good for My Patients? Marian Soat, MSN, RN, CCNS, CCRN

Introduction to 12 Lead ECGIschemia, Injury, InfarctionDeborah Klein, MSN, RN, APRN-BC, CCRN, FAHATheresa Cary, MSN, RN, ACNS-BC, CCRN

Ischemia, Injury, Infarction Axis DeterminationDeborah Klein, MSN, RN, APRN-BC, CCRN, FAHATheresa Cary, MSN, RN, ACNS-BC, CCRN

Page 5: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

Tuesday, September 25, 2012

3:00 - 3:30 PM BREAK / EXHIBITORS / POSTER DISPLAY

3:30 - 4:30 PM Session 22) Evaluation and Management of Critical Limb Ischemia to Achieve Limb Salvage Sean Lyden, MD

Session 23) Unusual Cardiac Case Studies Venugopal Menon, MD, FAHA, FACC

Session 24) Destination Therapy Challenges Maria Mountis, DO Session 25) Pulmonary Arterial Hypertension: How Do We Choose Therapies? Nancy Bair, MSN, RN, CNS-BC Joseph Parambil, MD

4:30 - 5:30 PM AACN LAKE ERIE CHAPTER SESSION: MEET AND GREET THE AACN PRESIDENT

5:30 - 7:30 PM NETWORKING NIGHT: Tours, Poster Display and Reception

7:00 - 7:45 AM REGISTRATION / CONTINENTAL BREAKFAST

7:45 - 8:00 AM WELCOME & ANNOUNCEMENTS

8:00 - 9:00 AM Session 26) Regression and Progression of Coronary Atherosclerosis Steven Nissen, MD, MACC

9:10 - 10:10 AM Session 27) Aortic Valve Disease: Medical and Surgical Management Lars Svensson, MD, PhD

Session 28) Esophageal Perforation Daniel Raymond, MD Session 29) Nurses Tackling Pain: A Win-Win Strategy Jennifer Colwill, MSN, RN, PCCN, CCNS Amy Kroen, BSN, RN Louis Pitschmann, MSSA, LISW-S Kathy Isaacson, BSN, RN Kenneth Bober, BSN, RN, CCRN Myra Cook, MSN, RN, ACNS-BC, CCRN

Session 30) New Oral Antithrombotic Agents: Is the Warfarin Era Over? Katherine Greenlee, PharmD, RPh, BCPS

Session 31) Long Term Effects of Immunosuppression Holli Blazey, MSN, RN, ANP-BC

10:10 - 10:45 AM BREAK / EXHIBITORS / POSTER DISPLAY

10:45 - 11:45 AM Session 32) Pacemakers and Implantable Cardioverter Defibrillators: The Basics for Bedside Nursing Karen Donatello, RN, RCIS, CCDS Dae Capobianco, CCDS, CEPS Session 33) Management of Pleural Effusions Kathleen Tripepi-Bova, MSN, RN, CCNS Session 34) Look, Listen, and Feel: Clues to Improving Your Vascular Assessment Skills Marsha Thompson, MSN, RN Session 35) Cardiothoracic Surgery Updates and Innovations Joseph Sabik, MD

Session 36) Nursing Care at the End of Life Christina Shane, MSN, RN, AOCNS

11:45 AM - 1:00 PM LUNCH / EXHIBITORS / POSTER DISPLAY

1:00 - 2:00 PM Session 37) Lung Transplant: Long Term Management Marie Budev, MD

Session 38) Thoracic Robotic Surgery Siva Raja, MD

Session 39) Therapeutic Hypothermia After Cardiac Arrest: What is the Evidence? Deborah Klein, MSN, RN, APRN-BC, CCRN, FAHA Session 40) Shared Governance Across the Continuum: Nursing Practice that Makes a Difference Jacqueline Spence, BSN, RN Bonnie Deran, BSN, RN Meghan Pishnery, BSN, RN, CCRN Myra Cook, MSN, RN, ACNS-BC, CCRN Session 41) Cardiac Assist Devices: Intra-Aortic Balloon Pump, Impella, TandemHeart Cathie Vacha, MSN, RN, ACNP Marjorie Urban, MSN, RN

2:10 - 3:10 PM Session 42) Heart 411 Marc Gillinov, MD

3:10 - 3:30 PM Evaluation / Wrap Up

3:30 PM Adjourn

2:00 - 3:00 PM Session 17) Endovascular Surgery Update Tara Mastracci, MD

Session 18) Cardiac Assist Devices: Quality of Life, Deactivation, and Other Ethical Considerations Leopoldo Pozuelo, MD, FACP, FAPM Martin Smith, STD

Session 19) Pregnancy in the Congenital Heart Survivor: Caring for Two Donna Patno, DNP, RN, CNM Session 20) Follow the Yellow Brick Road: Nurse Pathways/Career Development Dana Wade, MSN, RN, CNS-BC, CPHQ Leslie Simko, BSN, MS, RN Sandy Maag, BSN, RN Sandra Seidlecki, PhD, RN, CNS Marianela (Nelita) Zytkowski, DNP, RN-BC, NEA-BC Monica Weber, MSN, RN, CNS-BC, CIC, FAHA

Session 21) Professional Use of Social Media Marilena DiSilvio, RN, JD Cheryl O’Brien, BSN, RN, JD

Page 6: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

Dimensions in Cardiac Care 2012GENERAL INFORMATION

Hotel Accommodations A block of rooms has been reserved at ���)����8����������9�����'�$�=��reservation, contact the hotel directly via phone or on-line at www.ichotelsgroup.com. 5�����$���������S�$���������8����� 8���8��"���� ��U����8���S88����� ��!������� �������MPHV������������������������8��"���� �9�����MPWR�����;�����9�������MVV�����U����������

Individual guest reservations must be �� ������(K%���$��;'��������(�����to the scheduled arrival date to avoid a no-show charge.

Ground Transportation/Parking '������!� ����!�������"��$8��!�����9��=���)������������4�����������)����8����������9������5��=������!������������P����;�����!������J����=���������"��MP���������(�$���$�$�3�������=������!������������8��"���� �9����"����additional charge.

Map & DirectionsDirections to Cleveland Clinic campus can be accessed at www.clevelandclinic.org.

Special Events6�����������"���� ��������"��������%

;����(�;����$����W���P�X�%����H%W�5ZEVENING PANEL: Heart Failure Readmissions: An Interdisciplinary Approach to Patient and Family Education

Z����(�;����$����K���P�XK%W����%W�5ZAACN Lake Erie Chapter Session: Meet and Greet the AACN President

Z����(�;����$����K���P�X�%W���O%W�5ZNetworking Night: Tours, Poster Display and Reception

Conference Location InterContinental Hotel & Bank of America Conference CenterVR�P8�������4!����8��!������+���KKP�H5����%�PH�O�O�KP����ROO�O�O�RVVV#��%�PH�O�O�KP�P

Registration/Refund Policy5������������������� ������("����������������%��5Z�;';����$���PV���P��Early bird registration fees are available when payment is received on or before 4������K���P��\�� ������������?���������� ��!����� ���� ����F ����� ��������������� ���������������"��$���"�����PH�KKR��ORW�'����������"������������please do so onsite. In case of cancellation, a $100 cancellation fee will be deducted from your refund for the Full Conference registration ���M��"��$���;�����S�(#���" �� ������(;����$���PO���P��/+6�#&/S;_)**>�U)3�/4#'�6;�5'�Z>�6�����P��

Information For further information about this conference, contact the Cleveland Clinic Center for Continuing Education at:*� ��%�PH�KKR��OO�'���#���%R����WR�HO��_��4������%���� ��!����� ���� ����F ����� ���For questions about registering online, ����PH�KKR��OOO��email [email protected].

Americans with Disabilities ActThe Cleveland Clinic Foundation Center for Continuing Education fully intends to comply with the legal requirements of the Americans with Disabilities Act. If you need assistance, please notify us at least two weeks prior to the activity.

Page 7: The Nursing Institute presents Dimensions in Cardiac Care 2012 · 8/13/2012  · care nursing research or projects for consideration in the poster session. Non-research posters should

REGISTRATION Dimensions in Cardiac Care 2012September 23 – 25, 2012 InterContinental Hotel & Bank of America Conference | Cleveland, Ohio

PLEASE CIRCLE ALL THAT APPLYSUNDAY SEPTEMBER 238:00 AM - 4:30 PM (Please select either Track 1, 2 or 3)Track 1 12 Lead ECG InterpretationTrack 2 Electrophysiology/Cardiovascular Lab Track 3 Advanced Practice Nursing Pharmacology5:00 - 6:30 PM4 EVENING PANEL: Heart Failure Readmissions: An Interdisciplinary Approach to Patient and Family EducationMONDAY SEPTEMBER 248:00 - 8:50 AM5 The Future of Cardiac Surgery: Quality and Safety Initiatives8:50 - 9:40 AM6 AACN President’s Theme: Dare To10:30 - 11:30 AM (Please select one)7 Aortic Aneurysm Interventions and Nursing Considerations8 Is the Way We’ve Always Done It the Way to Always Do It?9 Chest X-ray Interpretation: The Basics and Beyond10 Innovations in Heart Valve Replacement11 Eliminating Codes Outside of the ICU: Is this Possible?12:50 - 1:50 PM (Please select one)12 Management of Venous Thromboembolism13 Understanding New and Updated Performance Measures in Heart Failure: What Does it Mean to Nursing Practice and Patient Care?14 Diabetes and Heart Disease: Glycemic Control15 Medical and Psychosocial Challenges of the Heart Transplant Recipient16 Becoming a Certified Nurse: Is it Good for Me? Is it Good for my Patients?2:00 - 3:00 PM (Please select one) 17 Endovascular Surgery Update18 Cardiac Assist Devices: Quality of Life, Deactivation, and Other Ethical Considerations19 Pregnancy in the Congenital Heart Survivor: Caring for Two20 Follow the Yellow Brick Road: Nurse Pathways/Career Development21 Professional Use of Social Media 3:30 - 4:30 PM (Please select one) 22 Evaluation and Management of Critical Limb Ischemia to Achieve Limb Salvage23 Unusual Cardiac Case Studies24 Destination Therapy Challenges25 Pulmonary Arterial Hypertension: How Do We Choose Therapies? TUESDAY SEPTEMBER 258:00 - 9:00 AM 26 Regression and Progression of Coronary Atherosclerosis9:10 - 10:10 AM (Please select one) 27 Aortic Valve Disease: Medical and Surgical Management28 Esophageal Perforation29 Nurses Tackling Pain: A Win-Win Strategy30 New Oral Antithrombotic Agents: Is the Warfarin Era Over?31 Long Term Effects of Immunosuppression10:45 - 11:45 AM (Please select one) 32 Pacemakers and Implantable Cardioverter-Defibrillators: The Basics for Bedside Nursing33 Management of Pleural Effusion 34 Look, Listen and Feel: Clues to Improving Your Vascular Assessment Skills35 Cardiothoracic Surgery Updates and Innovations36 Nursing Care at the End of Life 1:00 - 2:00 PM (Please select one) 37 Lung Transplant: Long Term Management38 Thoracic Robotic Surgery39 Therapeutic Hypothermia After Cardiac Arrest: What is the Evidence?40 Shared Governance Across the Continuum: Nursing Practice that Makes a Difference41 Cardiac Assist Devices: Intra-Aortic Balloon Pump, Impella, TandemHeart2:10 - 3:10 PM42 Heart 411

FULL CONFERENCE FEESCircle your Category

6�����������(��get the Early Bird 6���`

Early Bird 5�($���received on or ��"���RF�K

5�($���6� ��!��4"���RF��

Nurse MK�� MK��

;������ MP�� MP��

CC Employee M��� M���

889;F93)4"������� M��� M���

SINGLE DAY CONFERENCE FEES(Early Bird rate does not apply to single

day registration)Circle your Category

Category Sunday Monday Tuesday

Nurse MPO� MPO� MPO�

;������ MH� MH� MH�

CC Employee MP�� MP�� MP��

889;F93)4"������� MP�� MP�� MP��

Please circle all that apply

Sunday, September 23 Lunch Yes No

5����F6� ������ Yes No

Monday, September 24 Lunch Yes No

Z���QU����448/5��������?K%W�?�%W�5Z

Yes No

/�����=���/����%5�����S�����(���6� �������%W�?O%W�5Z

Yes No

9����Q3�� ����)��������'���� Yes No

Tuesday, September 25 Lunch Yes No

3���������Z����6�{����� Yes No

U�����#���Z����6�{����� Yes No

� �������������� ��������������������������������������������������������������������� ������������������

Pre-Registration Due by Wednesday, September 19, 2012, 6:00 pm ESTComplete the information below if registering by MAILor FAX

FEES:

REGISTER ONLINE: www.clevelandclinic.org/cardiaccare+� �(����������������������������$�����"�����������������"��$�Cleveland Clinic employees must register online only

Complete the information below if registering by mail or fax: (Please print)

_________________________________________________________________________________First Name Last Name MI Degree

_________________________________________________________________________________Title Specialty

_________________________________________________________________________________Company Name

_________________________________________________________________________________Address

_________________________________________________________________________________City State Zip

_________________________________________________________________________________Business Phone Email Address

Total amount enclosed or to be charged: $_______________

Make check payable to: The Cleveland Clinic Educational Foundation. Purchase orders are not accepted.or charge the following account: � Visa � MasterCard � American Express � Discover

Card number:________________________________________ Expiration date_________________ Signature________________________________________(not valid without signature)

Conference Fee includes: Program book, presentations in PDF format available online 7 days before conference and 60 days post conference; continental breakfasts, lunches, refreshment breaks, and receptions.

Fax Number: 216.448.0783Mailing address: The Cleveland Clinic Educational Foundation PO Box 931653, Cleveland, OH 44193-1082For questions about registration, please call 216.448.0777 or email [email protected]

Course #011941