Critical Care Newsline — August 7, 2008

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Critical Care Newsline, the electronic newsletter from the American Association of Critical-Care Nurses, contains information selected just for you by AACN. Every week, our expert clinical practice staff reviews hundreds of journals and Web sites, choosing only the most pertinent information for Critical Care Newsline. In each issue, you’ll find links to resources, research abstracts (individual sites may require registration and a fee to access complete articles) and Web sites on a variety of topics to keep you informed on issues that affect nurses and the nursing profession.


Aug. 7, 2008

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1. Research: New Scoring System Identifies Factors That Affect Mortality of Patients With Suspected Propofol Infusion Syndrome (Abstract)
2. News: Research, Creative Solutions and Chapter Poster Abstracts Sought for NTI 2009
3. Research: Immune System Protein Accurate Predictor of Survival in Pediatric Septic Shock (Abstract)
4. Event: AACN Certification Exams Offered at Fall TRENDS Conference
5. Research: Do Nighttime Transfers From the ICU Affect Patient Outcomes? (Abstract)
6. Research: Inappropriate Therapy for Methicillin-resistant Staphylococcus Aureus (MRSA) Impacts Resources and Healthcare Costs (Abstract)
7. Research: A Review for Nurses on the Essentials of HIV (Abstract)
8. Clinical Practice Resources
9. AACN Resources
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1. Research: New Scoring System Identifies Factors That Affect Mortality of Patients With Suspected Propofol Infusion Syndrome (Abstract)
Many characteristics are independently associated with higher mortality in patients who have suspected propofol infusion syndrome but only some of those are currently included in the medication’s package insert. Researchers of this study sought to identify predictors of mortality in patients with suspected propofol infusion syndrome and to develop a simple scoring system to identify patients with the condition most at risk of death. This research is important because many patients are treated with propofol, and awareness of the syndrome is now recognized as an emerging healthcare issue.
http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200808000-00010.htm;jsessionid=LZyXTvd4SnZxBnpJLmsqGgQd0RXkcb2kM8Wy5jZLFpSSLvMc3v1M!-193954295!181195628!8091!-1

2. News: Research, Creative Solutions and Chapter Poster Abstracts Sought for NTI 2009
AACN is inviting abstracts for poster presentation at next year’s NTI in New Orleans. The deadline to submit abstracts is Oct.15, 2008. You do not have to be an AACN member or customer to submit an abstract.
http://www.aacn.org/WD/NTI/Content/NTIEducation.pcms?menu=Education

3. Research: Immune System Protein Accurate Predictor of Survival in Pediatric Septic Shock (Abstract)
Despite today's potent antibiotics, septic shock remains a serious public health challenge. Sepsis sets off a chain reaction of events that can ultimately lead to uncontrolled inflammation in the body. About 4,000 children in the United States die every year from septic shock, and researchers are pushing the boundaries of molecular science to find new therapies that can stem the condition. But a simple measure of an immune system protein, Intereukin-8 (IL-8) within 24 hours of being admitted to the hospital for septic shock can predict survival in children, yielding a powerful tool for diagnostics and clinical trials of new septic shock therapies, according to research published in the Aug. 1 American Journal of Respiratory and Critical Care Medicine. The new study reports an IL-8 blood level at or below 220 pg/ml (picograms per milliliter) should allow healthcare providers to predict with 95 percent accuracy which children with septic shock can survive through conventional antibiotics and therapies for at least 28 days following admission. http://ajrccm.atsjournals.org/cgi/content/abstract/178/3/276?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=sepsis&searchid=1&FIRSTINDEX=0&volume=178&issue=3&resourcetype=HWCIT

4. Event: AACN Certification Exams Offered at Fall TRENDS Conference
Paper and pencil administration of the CCRN, PCCN, CCNS and ACNPC specialty certification exams and the CMC (Cardiac Medicine) and CSC (Cardiac Surgery) subspecialty certification exams will be offered on-site at the Fall TRENDS conference in Philadelphia, PA on Oct. 31, 2008. Please submit your TRENDs application and fee to AACN by Sept. 10, 2008.
http://www.aacn.org/WD/Certifications/Content/trends.pcms?menu=Certification

Certification validates nurses’ knowledge and skills, demonstrates their commitment to patient safety and gives them the confidence to handle any crisis. If you can’t make it to TRENDS for the paper and pencil exam, you can take an exam at one of our convenient computer based testing centers nationwide. Click on the following link for more information.
http://www.aacn.org/DM/MainPages/CertificationHome.aspx

5. Research: Do Nighttime Transfers From the ICU Affect Patient Outcomes? (Abstract)
Patients who were transferred from the ICU at night stayed in the hospital longer and were more likely to be readmitted to the ICU than those transferred during the day, according to this study. The researchers did not find a link between nighttime ICU discharge and hospital mortality, however.
http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200808000-00002.htm;jsessionid=LZ6DYY6FgmpqWfGxjRL0WzJXzHQkvFnLjRJvnzlywVstHLLZvLmF!982088527!181195629!8091!-1

6. Research: Inappropriate Therapy for Methicillin-resistant Staphylococcus Aureus (MRSA) Impacts Resources and Healthcare Costs (Abstract)
MRSA causes significant illness and death, and the use of initially inappropriate antibiotic therapy for the condition increases the risk of death. Initially inappropriate antibiotic therapy for MRSA increases the length of a patient’s hospital stay and impacts hospital costs. Researchers in this study suggest that efforts to lower rates of initially inappropriate antibiotic therapy for MRSA sterile-site infections will likely improve outcomes for both patients and for healthcare institutions. This study is important due to the endemic nature of MRSA in the resource intense and costly ICU environment.
http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200808000-00018.htm;jsessionid=LZ6Rq7Qz2bMskryB0Kh2KrlDmSpVNTVGygYr2n7thKNvvGzL8Gy1!982088527!181195629!8091!-1

7. Research: A Review for Nurses on the Essentials of HIV (Abstract)
Given the increasing number of HIV-infected individuals worldwide, knowledge of the basic pathogenesis of the disease and the principles of antiretroviral therapy is important for all healthcare professionals. This article describes epidemiologic trends in HIV and reviews HIV transmission, testing and treatment. It also discusses the risk of HIV transmission to healthcare workers from occupational exposures and reviews the use of post-exposure prophylaxis to reduce the likelihood of HIV transmission.
http://www.journalofinfusionnursing.com/pt/re/jinfusionnurse/abstract.00129804-200807000-00009.htm;jsessionid=LZ7NTJL8h2KswzHZnZbPJgc1TlG1Q0fZ2TwM0NbKYPQzjD3NZwm0!982088527!181195629!8091!-1

8. Clinical Practice Resources

PATIENT SAFETY ISSUES
Levitronix CentriMag Extracorporeal Blood Pumping System: risk of pump stoppage with use of certain electrosurgery units
http://www.fda.gov/medwatch/safety/2008/safety08.htm#CentriMag

Patient Safety Links:
Joint Commission
http://jcrinc.co.mansellgroup.net/UM/T.asp?A2557.25634.1623.1.63602
Medline Plus
http://jcrinc.co.mansellgroup.net/UM/T.asp?A2557.25634.1623.2.63602
National Patient Safety Foundation
http://jcrinc.co.mansellgroup.net/UM/T.asp?A2557.25634.1623.3.63602

Institute for Safe Medication Practices Newsletter
http://www.ismp.org/Newsletters/nursing/default.asp

AHRQ Patient Safety Network
http://psnet.ahrq.gov

NEW GUIDELINES
Assessment: oxygenation and blood pressure. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12318

Assessment: pupil examination. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12320

Decision making within the EMS system: dispatch, scene, transportation and destination. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12324

Treatment: airway, ventilation, and oxygenation. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12321

Treatment: cerebral herniation. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12323

Treatment: fluid resuscitation. In: Guidelines for the Prehospital Management of Severe Traumatic Brain Injury, second edition. This updates a previously published guideline summary.
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=12322

NEW EVIDENCE-BASED PRACTICE
Brain-type natriuretic peptide levels in the prediction of adverse outcome in patients with pulmonary embolism (Abstract)
http://ajrccm.atsjournals.org/cgi/content/abstract/178/4/425?etoc

Withdrawal assessment in the pediatric intensive care unit: Quantifying a morbidity of pain and sedation management in the critically ill child (Abstract)
http://amedeo.com/p2.php?id=18664814&s=crc

Blood glucose concentration and outcome of critical illness: The impact of diabetes (Abstract)
http://content.wkhealth.com/linkback/etoc/pt/abstract.00003246-200808000-00005.htm

Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients (Abstract)
http://content.wkhealth.com/linkback/etoc/pt/abstract.00003246-200808000-00001.htm

Early intensive care unit mobility therapy in the treatment of acute respiratory failure (Abstract)
http://content.wkhealth.com/linkback/etoc/pt/abstract.00003246-200808000-00003.htm

Withdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literature (Abstract)
http://amedeo.com/p2.php?id=18638332&s=crc

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