CriticalCare eNewsline — September 25, 2014

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September 25, 2014


ACTION - Request for comment

EVIDENCE - Factors that may influence weaning

NEWS - End-of-life care report

AACN UPDATE - Webinar on patient-focused collaboration




Communication leads to community, that is, to understanding, intimacy and mutual valuing.
— Rollo May



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Comment on cardiovascular nursing scope and standards

Submit comments and recommendations for the draft document “Cardiovascular Nursing Scope and Standards of Practice,” 2nd ed., from the Cardiovascular Nursing Scope and Standards Revision Workgroup, American Nurses Association, Silver Spring, Maryland. The deadline is Oct. 17, 5 p.m. ET.


Participate in national CNS census

The National Association of Clinical Nurse Specialists, Philadelphia, invites all nurses who identify themselves as a clinical nurse specialist (CNS) or were educated as a CNS to participate by Dec. 31 in the online 2014 CNS Census, which is collecting information on demographics, education and practice.


Participate in study on new nurse readiness

Merry van Zoeren, doctoral student at the University of Phoenix, invites critical care nurse preceptors who meet the criteria to participate in a study titled “New Nurse Readiness for Practice in Relationship to Hospital Patient Safety Culture From the Preceptor’s Perspective.” The confidential survey takes 10 to 15 minutes to complete. Please email van Zoeren with your questions.



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Article in AJCC finds task performance improves during shift

Using Simulation to Investigate the Impact of Hours Worked on Task Performance in an Intensive Care Unit,” in September’s American Journal of Critical Care (AJCC), finds that nurses take significantly less time to complete tasks at the end of their shift than at the beginning, with no significant changes in accuracy. The results suggest that nursing performance of simple tasks may improve over the course of a 12-hour shift.


CNE of the Month: Article in AJCC identifies factors that may influence weaning

Weaning From Mechanical Ventilation: A Scoping Review of Qualitative Studies,” a CNE article in September’s American Journal of Critical Care (AJCC), finds that interprofessional collaboration and communication, combining subjective knowledge of the patient with objective clinical data, balancing weaning systematization with individual needs and appreciation of the physical and psychological work of weaning are important factors that may influence weaning.


Mild potassium abnormalities

According to “Potassium Abnormalities in a Pediatric Intensive Care Unit: Frequency and Severity,” in September/October’s Journal of Intensive Care Medicine, mild potassium abnormalities are common in critically ill children.


Transfusion for septic shock may reduce mortality

In-Hospital Mortality Following Treatment With Red Blood Cell Transfusion or Inotropic Therapy During Early Goal-Directed Therapy for Septic Shock: A Retrospective Propensity-Adjusted Analysis,” posted online Sept. 12 in Critical Care, concludes red blood cell transfusion may decrease in-hospital mortality for patients with subnormal central venous oxygen saturation, despite meeting central venous pressure and mean arterial pressure goals.


Improving survival of ICU patients with sepsis

Rehabilitation within three months of discharge from the ICU reduces 10-year mortality risk in patients with sepsis who had comorbidities, required prolonged mechanical ventilation and had longer ICU stays, according to “Association of Post-Discharge Rehabilitation With Mortality in Intensive Care Unit Survivors of Sepsis,” first published online Sept. 11 in American Journal of Respiratory and Critical Care Medicine.


Nurse-managed protocols in management of chronic conditions

Effects of Nurse-Managed Protocols in the Outpatient Management of Adults With Chronic Conditions: A Systematic Review and Meta-Analysis,” in the July 15 Annals of Internal Medicine, finds these protocols may have positive effects on management of conditions such as diabetes, hypertension and hyperlipidemia. An accompanying editorial, “Are Nurses an Answer to New Primary Care Needs?” calls the findings welcome news.


Dyspnea in patients who are mechanically ventilated

January’s Intensive Care Medicine offers “Unrecognized Suffering in the ICU: Addressing Dyspnea in Mechanically Ventilated Patients,” which says dyspnea is common, is associated with pain and anxiety, and can be improved by adjusting ventilator settings.



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Volunteer response to Ebola outbreak; hospital checklist and webinar

The U.S. Agency for International Development, Washington, created a website to coordinate medical volunteer response to the Ebola outbreak in West Africa. Registrants’ information may be shared with nongovernmental organizations working in West Africa or with the Centers for Disease Control and Prevention (CDC), Atlanta. Also, access “Detailed Hospital Checklist for Ebola Preparedness” from the CDC and the Office of the Assistant Secretary for Preparedness and Response, Washington. A webinar on the checklist will be held Sept. 29, 3 p.m. ET.


Pneumococcal vaccine recommendations

On Sept. 19, the Centers for Disease Control and Prevention, Atlanta, published revised pneumococcal vaccine recommendations, including that adults 65 and older first should receive one dose of pneumococcal conjugate vaccine and then one dose of pneumococcal polysaccharide vaccine, ideally six to 12 months later. “Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP)” was published in Morbidity and Mortality Weekly Report.


IOM report calls for better end-of-life care

The U.S. healthcare system doesn’t meet the needs of patients nearing the end of life, according to “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life,” which was released Sept. 17 by the Institute of Medicine (IOM), Washington. Available to purchase, as a free PDF or to read online, the report calls for more advance care planning, better education for clinicians, and incentives for patients and clinicians to encourage discussion.



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New Choosing Wisely recommendations

On Sept. 15, the American Physical Therapy Association, Alexandria, Virginia, released a list of five items physical therapists and patients should question as part of Choosing Wisely, an initiative of the ABIM Foundation, Philadelphia. These recommendations include questioning bed rest after starting anticoagulants for deep vein thrombosis and whirlpools for wound management.


SCCM issues new guideline

On Sept. 8, the Society of Critical Care Medicine (SCCM), Mount Prospect, Illinois, released “Drug Shortage Alert: Alternative Medications for Procedural Sedation (Adults >18 Years of Age)” for clinicians to reference if a shortage arises.


Nursing ethics video and moral distress tool

Access the second in a series of videos from the National Nursing Ethics Summit, Aug. 13-15, at Johns Hopkins University School of Nursing, Baltimore. Participants were asked, “What Words or Phrases Describe an Environment Where Nurses Are Unable to Practice Ethically?” The first video in the series had responses to “What Keeps Nurses Up at Night?” Also, download a related tool from AACN — “The 4 A’s to Rise Above Moral Distress.”



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AACN webinar: Patient-Focused Collaboration

Explore the link between communication, collaboration and patient outcomes at AACN’s next live webinar, “Patient-Focused Collaboration: Strategic Alliances That Work,” Thursday, Oct. 9 at 10 a.m. PT. Join Hartford HealthCare senior administrator and alumnus CCRN Mary Bylone for a discussion of the impact of collaboration on patient care, strategies for effective communication and relationship building, and practical implementation tips. Free registration includes the webinar, implementation tools and access to the on-demand recording; CNE is available.


Focus the Flame

President's Note from September's AACN Bold Voices
“Driving Excellence Isn’t Another Chore”— Teri Lynn Kiss, AACN President 2014-2015



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Adult CCRN/CCRN-E Certification Review Course on CD-ROM (MAC)

Author: B. Leaper, MK Bader, C. Raun, S. Burns
Editor: AACN
(CD Rom, 2011)
Product Code:301951

In this comprehensive review course, a national panel of experts from the critical care nursing community prepares you for the CCRN or CCRN-E certification exam given by AACN Certification Corporation.

Created from a live webinar, the course weaves practice questions throughout each of seven modules. Compare your answers with those of your colleagues, and use the live-audience Q&A to enhance your learning of best practices from critical care units across the country.

AACN members receive 14.5 CNE hours at no additional charge after completing the entire review course; CNE fee for nonmembers is $25.

Includes PDF version of handout syllabus.

Member Price: $179 (Non-Member: $199)





PCCN Badge Holder

(Badge Holders, 2004)
Product Code:402504

Let the world know you are PCCN certified with a PCCN burgundy badge holder, featuring silver plating with tie-tack backing for easy display on fabric clothing, bags or bulletin boards.

Member Price: $3 (Non-Member: $3.50)





AACN Shopper Bag

(Tote Bags)
Product Code:402131

Brightly colored, laminated tote featuring the AACN Community logo. Great for shopping!

Member Price: $3 (Non-Member: $3.50)





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Work & play in Colorado Springs as Centura Health expands its cardiac services! Enjoy up to $5k sign on, relocation and Colorado’s exceptional lifestyle.
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Danbury Hospital is hosting an Open House for experienced RNs on October 7th from 5-7:30pm. Critical Care, Step Down, ED, NICU, PACU, L&D, Rapid Response.
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PICU Career Opportunities UVA Open House Sept. 27 - University of Virginia Medical Center

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The Pediatric Intensive Care Unit at the University of Virginia Medical Center is looking for nurses with a minimum of 2 years of PICU or pediatric acute experience.
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RN 2 West - ICU - Mayo Clinic

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The Department of Nursing at Mayo Clinic in Arizona has an opportunity for a Registered Nurse to join our team.
Read more about this position


Registered Nurse - Calvert Memorial Hospital

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