Critical Care Newsline — July 17, 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 17, 2008

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1. News: The Joint Commission Sets Standards to Halt Bad Behavior Among Healthcare Professionals
2. News: Nurses Take Steps to Guard Against Violent Patients
3. Research: The Power of Clinical Nursing Research: Engage Clinicians, Improve Patients’ Lives and Forge a Professional Legacy (Free Full Text)
4. Reminder: Circle of Excellence Awards Deadline Extended to Aug. 1, 2008
5. News: New York Ends Mandatory Overtime for Nurses
6. Resource: AACN President’s Theme Web Page
7. Event: Webinar on Improving Clinical Workspace Design to Enhance Patient Safety
8. Clinical Practice Resources
9. AACN Resources
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1. News: The Joint Commission Sets Standards to Halt Bad Behavior Among Healthcare Professionals
A new alert issued by The Joint Commission warns that rude language and hostile behavior among health care professionals goes beyond being unpleasant and poses a serious threat to patient safety and the overall quality of care. Intimidating and disruptive behaviors are such a serious issue that The Joint Commission is also introducing new standards requiring more than 15,000 accredited health care organizations to create a code of conduct that defines acceptable and unacceptable behaviors and to establish a formal process for managing unacceptable behavior. The new standards take effect Jan. 1, 2009 for hospitals, nursing homes, home health agencies, laboratories, ambulatory care facilities and behavioral health care facilities nationwide. Verbal outbursts, condescending attitudes, refusing to take part in assigned duties and physical threats all create breakdowns in the teamwork, communication and collaboration necessary to deliver patient care.
http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

AACN has long been an advocate of healthy work environments, which include respectful collaboration. Learn more about the AACN Standards for Establishing and Sustaining Healthy Work Environments. To download the standards, click on the following link.
http://www.aacn.org/WD/HWE/Content/hwehome.pcms?menu=Community

Also check out AACN’s position statement on Zero Tolerance for Abuse.
http://www.aacn.org/WD/Practice/Docs/Zero_Tolerance_for_Abuse.pdf

2. News: Nurses Take Steps to Guard Against Violent Patients
Nurses have increasingly become targets of violent, abusive patients and family members, and some have repeatedly suffered at the hands of those they care for, according to a recent article in the New York Times. As violence has increased, so have efforts by AACN and other nursing organizations, unions and hospitals to protect workers.
http://www.nytimes.com/2008/07/08/health/08nurses.html

AACN has taken a definitive stand against violence in the workplace. Given strong evidence that violence in the workplace threatens the delivery of effective, quality care and violates individual rights to personal dignity and integrity, we condemn acts of violence perpetrated by or against any person and call upon healthcare institutions to create organized programs to prevent and combat workplace violence. We believe it is the responsibility of every nurse and every employer to take immediate measures to address and prevent workplace violence. Read AACN’s position statement on workplace violence prevention.
http://www.aacn.org/WD/Practice/Docs/Workplace_Violence.pdf

Does your organization have an enforceable violence management policy? In AACN’s 2006 study of nurses’ work environments, less than half of the nurses responding reported their hospital had such a policy. Read the entire article at the following link.
http://ccn.aacnjournals.org/cgi/content/full/26/5/46?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=nurses+work+environment&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

3. Research: The Power of Clinical Nursing Research: Engage Clinicians, Improve Patients’ Lives and Forge a Professional Legacy (Free Full Text)
What distinguishes effective from ineffective hospital nursing research and evidence-based practice programs? According to research published in the July 2008 issue of the American Journal of Critical Care, it is infrastructure that supports processes to (1) unleash the creativity of staff by securing their involvement early, (2) educate staff by involving them, (3) create internal expertise for research and evidence-based practice, and (4) ensure that patients experience principled implementation of research-based practices to improve their lives. The article describes infrastructures that can ensure and sustain research-based practices while unleashing the talent and creativity of clinicians as they question practice and ponder the merits of current research. Fostering participation in such clinical inquiry will enhance professional growth, influence the lives of patients, and help each nurse develop a unique personal professional legacy.
http://ajcc.aacnjournals.org/cgi/content/full/17/4/315

4. 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. Historically, the awards program has focused on recognizing roles and practice situations. Beginning with the 2009 awards cycle, a single Circle of Excellence Award will replace the specific awards. Up to 25 individuals who exemplify excellence in the care of acutely and critically ill patients and their families will be chosen annually to receive the award. These recipients will become part of the new Circle of Excellence Society. You can learn more about the awards, review the criteria and fill out a nomination form by clicking on the following link. Practice meaningful recognition by nominating a worthy colleague.
http://www.aacn.org/awards

5. News: New York Ends Mandatory Overtime for Nurses
New York has passed legislation that bans mandatory overtime for nurses working in the state’s hospitals and nursing homes but not those working in home care, according to an article in the Long Island Newsday. Fourteen states now ban mandatory overtime.
http://www.newsday.com/services/newspaper/printedition/thursday/news/ny-stlegi195732275jun19,0,1643992.story

AACN encourages nurses to become active in influencing regulation and decisions that impact patient care.
To learn more about AACN’s position on mandatory overtime, click on the following link.
http://www.aacn.org/WD/Practice/Content/PublicPolicy/mandatoryovertime.pcms?menu=Practice

For more information on issues impacting nurses and patient care, visit AACN’s Legislative Action Center.
http://www.aacn.org/WD/Practice/Content/PublicPolicy/legislativeactioncenter.pcms?menu=Practice

6. Resource: AACN President’s Theme Web Page
Find out more about AACN President Caryl Goodyear-Bruch’s theme, “With Confidence,” by clicking on the link below, where you’ll find all things related to her theme in one convenient location; you can download and print a theme art poster, watch a video of Goodyear-Bruch’s theme speech at NTI 2008 and check out other “With Confidence” resources. In her speech, Goodyear Bruch says, “Sometimes you may feel like you’re just a nurse. But as a nurse, you are also nursing. You reflect on yourself and others every strength, every weakness, every good and every bad aspect of nursing. So when you transform into your confident self, you transform nursing.” Begin the transformation today; live and work with confidence!
http://www.aacn.org/confidence

7. Event: Webinar on Improving Clinical Workspace Design to Enhance Patient Safety
A free patient safety Webinar based on the 2007 Nursing Leadership Congress will be held from 1-2 p.m. (EDT) Aug. 1. The program, Physical Design and Workflow of an Organization to Support Patient Safety, will review the link between physical design, clinical workflow, and patient outcomes, and recommend steps nurse leaders can take to align design of the physical environment and clinical workflow to enhance patient safety. For details and registration information, click on the following link.
http://nursingleadershipcongress.com/webinars.asp

8. Clinical Practice Resources

PATIENT SAFETY ISSUES
Herceptin 440mg Vials & BWFI Diluent-Complaints of Damaged and Broken Vials That May Lead to a Loss of Sterility
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Herceptin

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
The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America (Free Full Text)
http://www.journals.uchicago.edu/doi/full/10.1086/589747

EVIDENCE-BASED PRACTICE
Informing Candidates for Solid-organ Transplantation About Donor Risk Factors (Extract)
http://content.nejm.org/cgi/content/extract/358/26/2832

SMART-COP: A Tool for Predicting the Need for Intensive Respiratory or Vasopressor Support in Community-Acquired Pneumonia (Abstract)
http://www.journals.uchicago.edu/doi/abs/10.1086/589754

Alterations During Medical Interpretation of ICU Family Conferences That Interfere With or Enhance Communication (Abstract)
http://www.chestjournal.org/cgi/content/abstract/134/1/109
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