Critical Care Newsline — July 3, 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 advanced 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.


July 3, 2008

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1. Research: Advanced Practice Providers Can Safely Perform Thoracostomies to Ease Trauma Staffing Shortages (Free Full Text)
2. Resource: AACN President’s Theme Web Page Now Live
3. Research: Study Shows High Rates, Rising Costs of Alcohol/Drug Disorders in Hospitalized Patients (Abstract)
4. News: Increasing Number of U.S. Residents Delay, Forgo Needed Health Care Because of Cost
5. Reminder: Circle of Excellence Awards Deadline Extended to Aug. 1, 2008
6. Resource: The American Heart Association's "Get With the Guidelines Program": Key Findings and Lessons Learned
7. Call to Action: Study on Work Environment, Moral Distress and Burnout in Adult Critical Care Nurses
8. Clinical Practice Resources
9. AACN Resources
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1. Research: Advanced Practice Providers Can Safely Perform Thoracostomies to Ease Trauma Staffing Shortages (Free Full Text)
Chest tube insertion performed by advanced practice providers (APPs) is consistent with that performed by trauma surgeons. Insertion by APPs—advanced registered nurse practitioners and physician assistants—may provide a safe and reasonable solution for understaffing in trauma centers, according to a report in the July 2008 issue of the American Journal of Critical Care. Results of the study support the conclusion that the quality of tube thoracostomies performed by APPs is neither statistically nor clinically inferior to that of tube thoracostomies performed by attending trauma surgeons. These findings add to the evidence that well-educated and supervised APPs may safely and competently enhance and expand the trauma/emergency center staffing model and thereby benefit such centers considerably, not only in this procedure but also in the overall care of trauma patients, according to the study’s researchers.
http://ajcc.aacnjournals.org/cgi/content/full/17/4/357

2. Resource: AACN President’s Theme Web Page Now Live
Find out more about AACN President Caryl Goodyear-Bruch’s theme, “With Confidence,” by clicking on the following link, where you’ll find all things related to her theme in one convenient location.
http://www.aacn.org/WD/Practice/Content/president-theme09.pcms?menu=Practice

3. Research: Study Shows High Rates, Rising Costs of Alcohol/Drug Disorders in Hospitalized Patients (Abstract)
Fourteen percent of patients admitted to the hospital have alcohol/drug abuse and addiction (ADAA) disorders, costs for which have risen sharply in recent years, according to a study in the June issue of the Journal of Substance Abuse Treatment (JSAT). The results lend insights into the scope and costs of ADAA disorders in hospitalized patients. According to the researchers, understanding ADAA's broad impact has implications for delivering better health care, decreasing ADAA-related illnesses and mortality, and reducing healthcare costs. Since alcohol and drug abuse are major contributors to leading causes of death—heart disease, cancer, and stroke—investing appropriate resources to ADAA treatment could reduce the costs of treating associated medical disorders. The researchers hope their results will serve as a baseline for evaluating efforts to manage ADAA in hospitalized patients, and to control their impact on health care costs.
http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(07)00237-1/abstract

4. News: Increasing Number of U.S. Residents Delay, Forgo Needed Health Care Because of Cost
The number of U.S. residents who delay or forgo necessary medical care because of cost concerns has increased significantly in the last four years, according to a report recently released by the Center for Studying Health System Change. About 20% of residents surveyed in 2007 said they had delayed or forgone necessary medical care at some point in the previous year, compared with 14% in 2003, according to the report. Among residents who said they had delayed or forgone necessary medical care in 2007, 69% cited cost concerns as a reason. The report found that 38% of uninsured residents said they had delayed or forgone necessary medical care in 2007. In addition, the report found that 17% of residents with health insurance said they had delayed or forgone necessary medical care in 2007, compared with 11% in 2003. Peter Cunningham, lead author of the report, said, "As health care costs increase, more of those costs are shifting to people and families." He added that many residents might have "reached a tipping point" in terms of ability to afford medical care amid increased costs.
http://hschange.org/CONTENT/994/

5. Reminder: Circle of Excellence Awards Deadline Extended to Aug. 1, 2008
The nominations deadline for the 2009 Circle of Excellence Awards has been extended to Aug. 1, 2008. For more information about these recognition awards click on the following link.
http://www.aacn.org/awards

6. Resource: The American Heart Association's "Get With the Guidelines Program": Key Findings and Lessons Learned
To improve the quality of care for patients hospitalized with cardiovascular disease, the AHA launched the "Get With the Guidelines" (GWTG) Program in the year 2001. Since that time, the program has produced a number of key findings and valuable lessons for measuring and improving the quality of cardiovascular care. Statistically significant and clinically relevant improvements in the use of key evidence-based therapies in coronary artery disease, stroke and heart failure modules have been shown in hospitals participating in the GWTG.
http://www.guideline.gov/resources/commentary.aspx?file=Get_with_the_Guidelines.inc

7. Call to Action: Study on Work Environment, Moral Distress and Burnout in Adult Critical Care Nurses
Critical care nurses are invited to take part in a research study on the impact of the critical care work environment. Participants will complete online questionnaires about their feelings and stressors as an adult critical care nurse and answer general questions about their background (age, gender, education, etc.) The study takes about 25 minutes.
https://www.surveymonkey.com/s.aspx?sm=KTPFH7Mw7iVYRPv_2b8Pw1SQ_3d_3d

8. Clinical Practice Resources

AACN HEALTHY WORK ENVIRONMENT STANDARDS
http://www.aacn.org/hwe

AHRQ WebM&M
http://webmm.ahrq.gov/

Quality Improvement Online
http://www.jcrinc.com/publications.asp?durki=9649

AACN PRACTICE ALERTS
http://www.aacn.org/WD/Practice/Content/practicealerts.pcms?menu=Practice

AACN’s LISTSERV FOR NURSE MANAGERS
http://health.groups.yahoo.com/group/NIHMBL/

PATIENT SAFETY ISSUES
2% Chlorhexidine Gluconate Cloth Patient Preoperative Skin Preparation Product Recalled: Bacteria Contamination
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Chlorhexidine

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

GUIDELINES
Diagnosis and Treatment of Gastroesophageal Reflux Disease (GERD)
http://www.guideline.gov/Compare/comparison.aspx?file=GERD1.inc

EVIDENCE-BASED PRACTICE
Intensive insulin Therapy and Mortality in Critically Ill Patients (Free Full Text)
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18312617

Epidemiology and Treatment of Painful Procedures in Neonates in Intensive Care Units (Abstract)
http://jama.ama-assn.org/cgi/content/abstract/300/1/60?etoc

Early Invasive vs. Conservative Treatment Strategies in Women and Men With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A Meta-analysis (Abstract)
http://jama.ama-assn.org/cgi/content/abstract/300/1/71?etoc

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