Critical Care Newsline — November 13, 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 13, 2008

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1. EVIDENCE Intensive Insulin Therapy Increases Risk of Hypoglycemia in Medical/Surgical ICU Patients (Abstract)
2. RESOURCE 2009 National Patient Safety Goals From the Joint Commission Now Available
3. EVENT Society for Healthcare Epidemiology of America (SHEA) Annual Meeting March 19-22
4. EVIDENCE End-of-Life Preferences Appear to Remain Stable as Health Declines (Abstract)
5. CALL FOR ABSTRACTS Live Educational Sessions for NTI 2010 in Washington, D.C.
6. EVENT Attend the 2009 Nurse in Washington Internship; Online Registration is Now Open
7. EVIDENCE Patients Generally Pleased With Hospital Care in the United States (Free Full Text)
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE Intensive Insulin Therapy Increases Risk of Hypoglycemia in Medical/Surgical ICU Patients (Abstract)
Intensive insulin therapy (IIT) does not appear to benefit patients in mixed medical/surgical units the way it does in separate surgical and medical ICUs, according to results of a recent study. Researchers found that patients in mixed medical/surgical ICUs who received IIT (80-100mg/dl) developed an increased risk of hypoglycemia when compared with those who received standard insulin therapy (120-200 mg/dl). In addition, patients’ risk of illness and death in the medical/surgical units did not diminish with IIT, the study noted. Previous studies have shown that IIT decreases morbidity and mortality in patients in a surgical ICU and decreases morbidity in patients in a medical ICU.

2. RESOURCE 2009 National Patient Safety Goals From the Joint Commission Now Available
The Joint Commission has released the 2009 version of its goals, with updates focused on improving the accuracy of patient identification, enhancing communication among caregivers, refining safety medications and reducing the risk of health care-associated infections. Revisions include a new numbering system and minor language changes for consistency.

3. EVENT Society for Healthcare Epidemiology of America (SHEA) Annual Meeting March 19-22
Those working in the fields of infection prevention and control and healthcare epidemiology face the challenges of merging science with cost-containment realities, adapting to local and federal pressures, and staying on top of emerging issues. SHEA's Annual Scientific Meeting brings together top clinicians, scientists, and practitioners to identify best practices, new technologies, and up-to-date advances to keep you on the forefront of patient care and healthcare worker safety.

For more on HAIs , read the Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals or view the related Web cast.

4. EVIDENCE End-of-Life Preferences Appear to Remain Stable as Health Declines (Abstract)
Most individuals’ preferences regarding life-sustaining treatment do not appear to change over a three-year period, regardless of declines in physical and mental health, according to a recent study. Those who say they want aggressive care and those without advance directives are most likely to change their end-of-life wishes over time. “Efforts to improve the experience of patients and families at the end of life must incorporate patient perspectives,” according to the study’s authors. “Advance directives are one strategy through which patient preferences can be elicited and recorded, to be invoked at a time when the patient may not be able to make decisions directing care.” However, they note, preferences for life-sustaining treatment given in one state of health may not reflect the choices patients would make if their health status changed.

Test your skill level and bridge any knowledge gaps with AACN's free Palliative and End-of-Life Care Self Assessment. The content features the self assessment plus resources for palliative care and end-of-life symptom management, airway management, dyspnea, delirium and pain management.

5. 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.

6. EVENT Attend the 2009 Nurse in Washington Internship; Online Registration is Now Open
Do you want to learn how to influence healthcare through legislative and regulatory processes? Here’s the perfect opportunity: attend the 2009 Nurse in Washington Internship (NIWI) program March 29 -31 in Washington, D.C. You’ll have a chance to attend talks by health policy experts and government officials, network with other nurses and visit members of Congress. NIWI is open to any RN or nursing student who is interested in the legislative process. For more information or to register, call (859) 514-9157 or click here.

AACN collaborates with other national organizations to address issues that affect professional nursing practice and achievement of AACN's vision. We provide information and educational materials to our members regarding issues that affect the nursing profession, practice of critical care nursing and the patients and families that we care for. Find out more by visiting our Legislative Action Center.

7. EVIDENCE Patients Generally Pleased With Hospital Care in the United States (Free Full Text)
In the first study of its kind to determine patients’ perception of care in U.S. hospitals, researchers found that patients have moderately high levels of satisfaction with their care. The quality of clinical care and certain hospital characteristics, such as a higher ratio of nurses to patient-days, were associated with greater patient satisfaction. The study’s authors, who used data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) noted, “Just as the public release of data on clinical performance has prompted improvements in clinical care, the regular reporting of patient satisfaction measures could similarly stimulate hospitals to deliver patient-centered care.”

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Hemodynamic Changes During Weaning From Nasal Continuous Positive Airway Pressure (Abstract)

The Effect of a Quantitative Resuscitation Strategy on Mortality in Patients with Sepsis: A Meta-analysis (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
Propafenone HCl, Isosorbide Mononitrate Extended Release, Morphine Sulfate Immediate and Extended Release, Dextroamphetamine Sulfate- Products Recalled Due To The Potential For Oversized Tablets

Wal-Mart "ReliOn" Insulin Syringe Recall Due to Potential for Serious Overdose
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