CriticalCare eNewsline — June 13, 2013

NEWS - CDC issues health advisory on Middle East virus

NEWS - June 26: CDC call on fall prevention

ACTION - June 20: free AACN webinar

EVIDENCE - Review on head-of-bed elevation

“Intervention Research: Designing, Conducting, Analyzing, and Funding,"
by Bernadette Mazurek Melnyk and Dianne Morrison-Beedy

Participate in study on family presence in adult critical care

Debra Stauffer, a PhD student at Washington State University in Spokane, invites critical care nurses to participate in a study about their perspectives on family presence in critical care and how factors in the practice environment may contribute to their decision to invite family presence. The confidential, online survey takes about 15 minutes to complete. Email Stauffer with questions.

June 20: Managing Alarm Fatigue, next webinar in AACN’s free series

Register for the third event in the free AACN Critical Care Webinar Series: “Managing Alarm Fatigue: New Approaches and Best Practices,” Thursday, June 20, 10 a.m. PT, presented by Marjorie Funk, Maria Cvach and Sue Sendelbach. Join this expert panel as they explore the scope of the problem, management of environmental alarms for improved patient safety and strategies for creating a more effective (and quieter) workplace. Registration includes the live session, implementation tools and access to the recorded webcast. Learn more and register.

CNE article in CCN reviews guidelines for head-of-bed elevation

“Head-of-Bed Elevation in Critically Ill Patients: A Review,” a continuing nursing education (CNE) article in June’s Critical Care Nurse (CCN), discusses guidelines for head-of-bed elevation to prevent aspiration and pressure ulcers.

Universal decolonization effective for reducing MRSA in ICU

“Targeted versus Universal Decolonization to Prevent ICU Infection,” which The New England Journal of Medicine published online May 29, finds universal decolonization is “more effective than targeted decolonization or screening and isolation” in reducing methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates and bloodstream infection from any pathogen.

Progressive physiotherapy in ICU patients improves function, shortens LOS

Early progressive physiotherapy in ICU patients can improve function and shorten hospital length of stay (LOS), according to “Physiotherapy in Intensive Care. An Updated Systematic Review,” which CHEST posted online May 30.

Bariatric surgery in adults with diabetes

“Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes: A Systematic Review” finds that when compared with nonsurgical interventions, bariatric surgery in patients with diabetes who have a body mass index of 30 to 35 is associated with “greater short-term weight loss and better intermediate glucose outcomes.” However, the review, in the June 5 JAMA: The Journal of the American Medical Association, cautions that evidence is “insufficient” to establish appropriate use in these patients until more data for long-term outcomes and surgical complications are available.

Studies on pediatric sedation and on postintubation radiograph

June’s Pediatric Critical Care Medicine includes two studies of interest to nurses: 1) “A Dose-Response Study of Dexmedetomidine Administered as the Primary Sedative in Infants Following Open Heart Surgery” notes that continuous infusion of dexmedetomidine can improve sedation and reduce supplemental medication requirements, “leading to successful extubation,” and 2) “The Impact of Postintubation Chest Radiograph During Pediatric and Neonatal Critical Care Transport” finds that radiographs from children intubated by a transport team “remain informative” and should be obtained when feasible.

CDC issues health advisory on Middle East virus

On June 7, the Centers for Disease Control and Prevention (CDC), Atlanta, issued “Notice to Health Care Providers: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated With Middle East Respiratory Syndrome Coronavirus (MERS-CoV),” which includes background information, recommendations and case definitions. On May 29, Kathleen Sebelius, secretary for the Department of Health and Human Services, Washington, D.C., issued a statement that MERS-CoV has “significant potential for a public health emergency” and authorized the emergency use of in vitro diagnostics, not yet approved by the U.S. Food and Drug Administration, Silver Spring, Md., for detecting the virus. As of June 7, there were 55 cases of MERS-CoV, with 31 deaths, none in the U.S.

June 26: CDC call on fall prevention

Register for the Centers for Disease Control and Prevention’s (CDC’s) call: “Implementing Clinical Fall Prevention in Your Practice: The STEADI Tool Kit for Health Care Providers,” Wednesday, June 26, 3-4 p.m. ET. The Stopping Elderly Accidents, Deaths & Injuries (STEADI) Tool Kit can help you assess, treat and refer older adult patients based on their fall risk. Join the call to learn about the development of STEADI Tool Kit methods for incorporating the resources into your practice and the financial incentives.

Guideline for management of ST-segment elevation myocardial infarction

Access the Agency for Healthcare Research and Quality, Rockville, Md., summary of “2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines,” from January’s JACC: Journal of the American College of Cardiology.

Algorithms for evaluating ADRs in the ICU

The Kramer algorithm, Naranjo criteria and Jones algorithm are equally valuable tools for retrospective evaluation of adverse drug reactions (ADRs), according to “Comparison of Three Pharmacovigilance Algorithms in the ICU Setting: A Retrospective and Prospective Evaluation of ADRs.” The three tools have greater variability when used for concurrent ADR evaluations, notes the study in August 2012’s Drug Safety: An International Journal of Medical Toxicology and Drug Experience.

Guideline for antimicrobial prophylaxis in surgery

Access the Agency for Healthcare Research and Quality, Rockville, Md., summary of “Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery,” from February’s AJHP: American Journal of Health-System Pharmacy.

Carvedilol reduces mortality in patients with HF and implantable defibrillators

“Effect of Metoprolol versus Carvedilol on Outcomes in MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)” finds that in patients with wide QRS complexes and functional class I or II heart failure (HF), carvedilol “was associated with” a 30 percent reduction in death or hospitalization for HF when compared to metoprolol. A beneficial and “synergistic” effect of carvedilol was seen in patients who had CRT with an implantable cardioverter-defibrillator and left bundle branch block, according to this study, which JACC: Journal of the American College of Cardiology published April 9.

June 14: CNE/CERP NTI evaluation forms due

If you attended this year’s National Teaching Institute & Critical Care Exposition (NTI) in Boston, submit your program and session evaluations online or through your mobile device for continuing nursing education (CNE) hours and/or CERP credit by June 14, 11:59 p.m. PT. After June 14, you may only print your certificate.

Dare To

From June's AACN Bold Voices
“Dare To: What Have We Learned?” — Kathryn Roberts, AACN President 2012-2013