Critical Care Newsline — November 6, 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.

Nov. 6

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1. EVIDENCE Glycemic Variability Linked to Death Rate in Critically Ill Patients
2. RESOURCE: Free Report on Pulmonary Artery Catheter Use
3. CALL TO ACTION Submit Nominations for the 2010 Distinguished Research Lecturer; Deadline Is Dec.1, 2008
4. EVENT 2009 Advanced Public Policy Institute for Health Professionals
5. NEWS NTI 2009 Housing Bureau Now Open
6. EVIDENCE Anticholinergic Inhalers Linked to Heart Problems, Death in COPD Patients
7. RESOURCE AACN President’s Theme Creates Confidence, Empowerment
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE Glycemic Variability Linked to Death Rate in Critically Ill Patients
Glycemic variability, an assessment of how much a patient’s glucose level deviates from the norm, is an important predictor of mortality in critically ill patients, according to a recent retrospective literature review.
The report’s authors found that increasing glycemic variability upped a patient’s risk of dying. The authors also noted, “Previously published interventional studies of glycemic control may be reinterpreted using the metric of glycemic variability. Measures to ensure a low degree of glycemic variability may improve outcomes in intensive care units implementing glycemic control.”

2. RESOURCE: Free Report on Pulmonary Artery Catheter Use
An 81-page report titled “Evaluation of the Evidence on Benefits and Harms of Pulmonary Artery Catheter Use in Critical Care Settings” has been published to help healthcare professionals assess the use of PAC technology in the Medicare population. The document was prepared by Tufts Medical Center Evidence-based Practice Center in response to a request by the Center for Medicare & Medicaid Services The report describes the relative effect and safety of PAC monitoring and how it affects outcomes in patients age 65 and older who are hospitalized in critical care settings.

For more on this topic, refer to AACN’s Practice Alert on Pulmonary Artery Pressure Measurement.

3. CALL TO ACTION Submit Nominations for the 2010 Distinguished Research Lecturer; Deadline Is Dec.1, 2008
AACN is accepting nominations for the 2010 Distinguished Research Lecturer. The recipient will receive a plaque and present the Distinguished Research Lecture at 2010 NTI in Washington, D.C. The award is sponsored by Philips Medical Systems and consists of a $1,000 honorarium and an additional $1,000 for NTI expenses. The ideal candidate will be 1) nationally recognized for publications, presentations, and/or mentorship in research relevant to acute and/or critical care clinical practice, 2) viewed as a consultant in his or her area of expertise 3) known for significant contributions to acute and critical care nursing practice through research 4) a dynamic and interesting speaker (nominators should cite an example of nominee's expertise in public speaking). For more information click here or e-mail research@aacn.org.

4. EVENT 2009 Advanced Public Policy Institute for Health Professionals
The Advanced Public Policy Institute for Health Professionals (PPI) will be held Feb.18-20, 2009 in Washington, DC. The PPI, sponsored by the American College of Nurse Practitioners, provides participants with in-depth presentations on key legislative and regulatory issues facing health professionals. Topics include: behind-the-scenes Washington scenarios; nuts and bolts of health issues in Congress and the Administration; revisiting Medicare and Medicaid; state Scope of Practice issues; future informatics and telecommunications advances; changes coming in insurance market; forces impacting economics of health care; current legislative issues for health professionals; and the need for development of a leadership presence in health professionals.

5. NEWS NTI 2009 Housing Bureau Now Open
Book your hotel room online for NTI 2009 in New Orleans May 16-21. Check out the list of accommodations and rates and make your reservations now. The best rooms are only a click away.

6. EVIDENCE Anticholinergic Inhalers Linked to Heart Problems, Death in COPD Patients
Inhaler drugs used by millions of people with emphysema and bronchitis may slightly raise the risk for heart attacks and even death, a study suggests. The study’s authors pooled results from 17 randomized studies comparing mostly older patients on either ipratropium bromide or tiotropium bromide with those on different medicine or dummy drugs. The researchers found that using either drug for more than one month appeared to increase chances for fatal and nonfatal heart problems including heart attacks by more than 50 percent. Among about 7,400 patients on either inhaled drug, 1.8 percent or 135 people developed fatal or nonfatal heart problems over a period of several weeks to several years. By contrast, among about 7,300 patients on other drugs or placebos, 1.2 percent or 86 had those problems. Researchers acknowledged that inhalers provide significant relief for these patients struggling to breathe; however, they urged doctors to closely monitor patients who use the inhalers, particularly those who have both emphysema and chronic bronchitis.

7. RESOURCE AACN President’s Theme Creates Confidence, Empowerment
AACN President Caryl Goodyear-Bruch says, “I chose ‘With Confidence’ as the theme for my presidential year because I want to encourage acute and critical care nurses to recognize and embrace the power they have. ‘With Confidence’ affirms the value of your everyday contributions and empowers you to create the workplace you envision for you and your patients.” Click here to find all things related to the theme in one convenient location.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Central Venous Oxygen Saturation Cannot Replace Mixed Venous Saturation in Patients Undergoing Cardiac Surgery

GUIDELINES
Delirium: Prevention, Early Recognition, and Treatment. In: Evidence-based Geriatric Nursing Protocols for Best Practice

PATIENT SAFETY ISSUES
Thoratec HeartMate II Left Ventricular Assist System- Device Correction: Wear and Fatigue of the Percutaneous Lead Connecting the Blood Pump With the System Controller May Cause Serious Injury or Death
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