Critical Care Newsline — December 4, 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’s clinical practice experts. 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 that will keep you informed on issues affecting nurses and the nursing profession.

Dec 4, 2008

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1. NEWS Nurses Continue to Shine in Gallup Ethics Ratings
2. EVIDENCE Heart Disease Patients May Not Benefit from Depression Screening (Abstract)
3. EVIDENCE Practical Guidance for Evidence-based ICU Family Conferences (Abstract)
4. RESOURCE NIOSH Issues PPE Guidelines to Shield Healthcare Workers From Drug Hazards
5. EVIDENCE Study Reveals Smoking's Effect on Nurses' Health, Death Rates (Abstract)
6. CALL FOR APPLICATIONS AACN Nursing Research Grants Deadline Is Jan. 1, 2009
7. CALL FOR ABSTRACTS Live Educational Sessions for NTI 2010 in Washington, D.C.
8. Clinical Practice Resources
9. AACN Resources
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1. NEWS Nurses Continue to Shine in Gallup Ethics Ratings
For the seventh straight year, nurses enjoyed top public accolades in Gallup's annual Honesty and Ethics of professions survey. Eighty-four percent of Americans rate nurses’ honesty and ethical standards either "high" or "very high." Since the profession was added to the list in 1999, nurses have ranked first in the poll every year except 2001. Congratulations, and thank you for providing exceptional patient care—and for doing your job with truthfulness and integrity.

2. EVIDENCE Heart Disease Patients May Not Benefit from Depression Screening (Abstract)
Results of a new study question recent clinical guidelines issued by leading cardiovascular groups, including the American Heart Association, which recommend patients with heart disease be screened for signs of depression and treated accordingly. The study’s authors did not find clear evidence that depression screening plays a conclusive role in improving cardiovascular patients' health. Nor did they find that treating depression delayed subsequent heart attacks or improved survival, although they added that relevant data were limited. Nearly one in five patients with cardiovascular disease suffer from major depressive disorder, but because some heart disease symptoms can be confused with signs of depression, standard screening tools for depression may not be appropriate for these patients, the study suggests.

3. EVIDENCE Practical Guidance for Evidence-based ICU Family Conferences (Abstract)
The quality of communication between clinicians and family members of ICU patients has direct bearing on decisions made regarding the care of these patients, according to a recent study. The study’s authors also found that clinician-family communication can also have a profound effect on the experiences and long-term mental health of family members. “Communication with family members in the ICU setting is complex,’ researchers noted, “and high-quality communication requires training and collaboration of a well-functioning interdisciplinary team. This communication also requires a balance between adhering to processes of care that are associated with improved outcomes and individualizing communication to the unique needs of the family.”

For more guidelines on family conferences, read the Practice Resource Network Q&A in the October 2008 issue of AACN News.

4. RESOURCE NIOSH Issues PPE Guidelines to Shield Healthcare Workers From Drug Hazards
The National Institute for Occupational Safety and Health (NIOSH) recently issued guidelines for using personal protective equipment (PPE) to protect healthcare workers who work with hazardous drugs. Healthcare workers who handle hazardous drugs are at risk of skin rashes, cancer and reproductive disorders.

5. EVIDENCE Study Reveals Smoking's Effect on Nurses' Health, Death Rates (Abstract)
A new study is the first to reveal the devastating consequences of smoking on the nursing profession. The findings describe smoking trends among nurses and emphasize the importance of supporting smoking cessation programs for U.S. nurses. The study’s researchers analyzed data from the Nurses' Health Study, a historic study on women's health, and explored changes in smoking trends and death rates among female nurses enrolled in the Nurses' Health Study between 1976 and 2003, a span of 27 years. In all age groups, roughly twice as many current smokers had died in comparison to nurses who never smoked. "Death rates among former smokers that age were 1.5 times higher than those of non-smokers, while current smokers were 2.3 times more likely to have died by that age than nurses who never smoked," researchers reported. The rate of smoking among women in the Nurses' Health Study declined from 33.2 percent in 1976 to 8.4 percent in 2003. The number of cigarettes smoked per day also dropped. However, current smokers still averaged more than 15 cigarettes, or over half a pack.

For more information on this topic, read the Clinical Practice Guideline for Treating Tobacco Use and Dependence 2008 Update and an AACN CE article, Evidence Based Strategies for Tobacco Cessation.

6. CALL FOR APPLICATIONS AACN Nursing Research Grants Deadline Is Jan. 1, 2009
Only a few weeks remain to submit applications for AACN nursing research grants focusing on: Clinical Inquiry, End-of-Life Palliative Care, Evidence-Based Clinical Practice, Mentorship and Critical Care. For specific information about these grants, click here.

7. CALL FOR ABSTRACTS Live Educational Sessions for NTI 2010 in Washington, D.C.
AACN is accepting abstracts for live educational sessions to be presented at NTI 2010. Abstracts selected for presentation must reflect AACN’s mission, vision and values; support AACN’s major areas of interest; link research and practice; present cutting edge information and contain precise, comprehensive content. The deadline is June 1, 2009.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Pressure Characteristics of Mechanical Ventilation and Incidence of Pneumothorax Before and After the Implementation of Protective Lung Strategies in the Management of Pediatric Patients With Severe ARDS (Abstract)

Pediatric Cardiopulmonary Resuscitation: Advances in Science, Techniques and Outcomes (Abstract)

GUIDELINES
Guidelines for Evaluation of New Fever in Critically Ill Adult Patients: 2008 Update from the American College of Critical Care Medicine and the Infectious Disease Society of America. (This updates a previously published guideline summary.)

Recommendations for End-of-life Care in the Intensive Care Unit: A Consensus Statement by the American Academy of Critical Care Medicine. (This updates a previously published guideline summary.)

Recommendations for the Diagnosis and Management of Corticosteroid Insufficiency in Critically Ill Adult Patients: Consensus Statements From an International Task Force by the American College of Critical Care Medicine.

PATIENT SAFETY ISSUES
Phenytoin and Fosphenytoin Sodium Associated With Potential Increased Risk of Serious Skin Reactions
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