Critical Care Newsline — October 9, 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.


Oct. 9, 2008

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1. NEWS NTI 2009 Housing Bureau Now Open
2. CALL TO ACTION Submit Your Best Practices on Building a Culture of Certification
3. CALL FOR ABSTRACTS Live Educational Sessions for NTI 2010 in Washington, D.C.
4. EVIDENCE Seniors and Statins: Delirium Risk Rises After Surgery (Abstract)
5. NEWS Revisit the GE Healthcare-AACN NTI 2008 e-Sampler; CE Content Added
6. EVIDENCE Bleeding in the Brain: Blood Thinner Increases Risk (Abstract)
7. NEWS Anticoagulant Alert: Heparin, Warfarin Potentially Dangerous, Warns Joint Commission
8. Clinical Practice Resources
9. AACN Resources
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1. 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.

2. CALL TO ACTION Submit Your Best Practices on Building a Culture of Certification
If you’ve been involved in successfully establishing a culture of certification at your workplace or through your AACN chapter, we want to hear from you. Send us your best practices by filling out the online submission form where you can describe your best practice, your role in the process and the barriers you and your colleagues faced implementing it. You can submit a best practice anytime but if your submission is received by Oct. 17, 2008 it may be one of those selected for presentation in the mastery session, “Building a Culture of Certification: Best Practices Roundtable” at NTI 2009 in New Orleans.

3. CALL FOR ABSTRACTS Live Educational Sessions for NTI 2010 in Washington, D.C.
Now’s the time to submit your abstracts for live educational sessions to be presented at NTI 2010. Abstracts accepted 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.

4. EVIDENCE Seniors and Statins: Delirium Risk Rises After Surgery (Abstract)
Elderly patients who took statins in the year before undergoing elective, noncardiac surgery were 28% more likely to experience postoperative delirium, according to a recent study. Those at greatest risk underwent longer surgeries and were older than age 70. "The association between statins and risk of delirium was distinct and was not observed with other lipid-lowering medications, cardiovascular medications or common drugs that reflect underlying chronic diseases but have no major effects on the cardiovascular system," researchers reported. In addition to causing anxiety for patients and their families, delirium can disrupt and delay care, contributing to longer hospital stays and prolonging the need for intensive care treatment.

Test your own skill level and bridge any knowledge gaps that you may have about delirium and other topics with the free, newly released Palliative and End-of-Life Care Self Assessment. The content includes the self assessment and resources for palliative care and end-of-life symptom management, airway management, dyspnea, delirium and pain management.

5. NEWS Revisit the GE Healthcare-AACN NTI 2008 e-Sampler; CE Content Added
Want to find out more about NTI? Check out the newly updated NTI 2008 e-Sampler on AACN’s Web page, where you’ll find links to two concurrent sessions (with free CE) along with inspiring talks by AACN leaders. These select sessions presented by GE Healthcare and AACN give you just a taste of what it’s like to attend the premier conference and trade show for nurses who care for acutely and critically ill patients. Share the following link with your colleagues—and plan now to attend NTI 2009 in New Orleans.

6. EVIDENCE Bleeding in the Brain: Blood Thinner Increases Risk (Abstract)
A new study shows that people who take the commonly used blood thinning drug warfarin may have larger amounts of bleeding in the brain and increased risk of death if they suffer a hemorrhagic stroke. Although warfarin may help prevent ischemic stroke for patients with atrial fibrillation, the drug may also make the blood too thin, increasing the risk of brain hemorrhage. The study’s researchers found that people who took warfarin and suffered a brain hemorrhage while their international normalized ratio (INR) was above three had about twice as much initial bleeding as those not taking warfarin. However, this effect did not occur in people whose blood was more likely to clot at an INR of less than three. "Warfarin is very effective for preventing ischemic strokes among people with atrial fibrillation, and for most patients with this condition it is the right choice," researchers noted, adding that closely monitoring and adjusting warfarin dose is crucial. “People should talk to their doctors about the proper management of warfarin and learn the signs of stroke so they can get to an emergency room immediately if a stroke occurs."

7. NEWS Anticoagulant Alert: Heparin, Warfarin Potentially Dangerous, Warns Joint Commission
The Joint Commission’s new Sentinel Event Alert urges greater attention to the dangers associated with anticoagulants, life-saving medications that also present serious risks when administered incorrectly or in error. Patients being treated with these medications must be closely monitored and screened for drug and food interactions because commonly used anticoagulants such as heparin and warfarin have narrow therapeutic ranges and a high potential for complications. Adding to the problem is a lack of standardized naming, labeling and packaging of anticoagulants that create confusion and lead to devastating errors.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Duration of Withdrawal of Life Support in the Intensive Care Unit and Association with Family Satisfaction (Abstract)

Determinants of Regional Cerebral Oxygenation in Children with Sleep-disordered Breathing (Abstract)

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

PATIENT SAFETY ISSUES
Class I Recall: Medtronic Neuromodulation INDURA One-Piece Intrathecal Catheters, Sutureless Pump Connector Revision Kit and Intrathecal Catheter Pump Segment Revision Kit

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