Critical Care Newsline — September 18, 2008

Critical Care Newline Home


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.


Sept 18, 2008

********************************************.

1. EDUCATION AACN Launches New Palliative Care, Preceptor E-Learning Programs
2. RESOURCE FDA Posts First Quarterly Report on Drugs With Potential Safety Issues (Abstract)
3. EVIDENCE Antibiotic Cycling Reduces MRSA Infections in the ICU (Abstract)
4. EVIDENCE New Acute Kidney Injury Criteria Pinpoints Clinical Outcomes for Critical Care Patients (Abstract)
5. EVIDENCE VAP-PIRO Assesses Severity of Ventilator Associated Pneumonia (Abstract)
6. EVENT Attend the 2009 Nurse in Washington Internship; Online Registration Is Now Open
7. EVIDENCE Internet-based Instruction: An Effective Teaching Tool for Healthcare Professionals (Abstract)
8. Clinical Practice Resources
9. AACN Resources
************************************************

1. EDUCATION AACN Launches New Palliative Care, Preceptor E-Learning Programs
Two eagerly anticipated e-learning courses, “Promoting Excellence in Palliative and End-of-Life Care: An Interactive Learning Experience from AACN” and “The Preceptor Challenge: The AACN Preceptor Development Program” are now online. Both interactive courses help acute and critical care nurses enhance their knowledge and experience in a safe, simulated environment. And, like all programs in AACN’s E-Learning catalog, they are easy to navigate, self-paced and cost effective. If your organization already has an AACN E-Learning system site license, you can immediately access the programs. If your hospital doesn’t have a site license, ask about obtaining one so you and your colleagues can take advantage of all AACN’s innovative E-Learning courses.

2. RESOURCE FDA Posts First Quarterly Report on Drugs With Potential Safety Issues (Abstract)
The U.S. Food and Drug Administration recently posted the first list of 20 drugs being evaluated for potential safety issues on its Web site. Each quarter, a new report will list other drugs under evaluation. "Patients and healthcare professionals have told us that they want to be informed about possible safety problems sooner,” the agency reports. “They want to know when the FDA is in the early stages of looking into a potential safety problem. Congress took note of this when it directed us to post this quarterly report of potential safety issues."

3. EVIDENCE Antibiotic Cycling Reduces MRSA Infections in the ICU (Abstract)
Switching between two antibiotics, linezolid and vancomycin, every three months in a surgical ICU significantly decreased MRSA-related deaths and infections, according to a recent study published in Surgical Infections. Researchers reported that antibiotic cycling lowered the MRSA infection rate from 1.9 to 1.4 patients per 100 admissions, and the in-hospital mortality rate from MRSA fell from 3.8 patients per year to none. “Before we began cycling, 67 percent of the Staphylococcus aureus infections in our surgical ICU were caused by MRSA,” the investigators noted. “Cycling reduced MRSA cases to 36 percent of that total.” The study is the first to assess the impact of antibiotic cycling on gram-positive cocci, a group of bacteria that develops resistance to antibiotics in sterile, contained environments like the ICU. Patients in these units are particularly vulnerable because their immune systems have been weakened by disease or injury.

4. EVIDENCE New Acute Kidney Injury Criteria Pinpoints Clinical Outcomes for Critical Care Patients (Abstract)
A new definition for acute kidney injury—one of the risks ICU patients face—helps healthcare providers predict hospital mortality, the need for renal replacement therapy and the odds of prolonged hospital stay in critically ill patients, according to results of a recent study. The study’s researchers also found that an increment of serum creatinine >=0.3 mg/dL in 48 hours alone can be an accurate predictor of clinical outcomes for patients with acute kidney injury.

5. EVIDENCE VAP-PIRO Assesses Severity of Ventilator Associated Pneumonia (Abstract)
Ventilator Associated Pneumonia (VAP) is an all-too-common complication that develops in intubated, mechanically ventilated patients, partly because healthcare professionals have not had an effective way to predict its occurrence. That may soon change, thanks to development of a new assessment tool called VAP PIRO. Using a simple, 4-variable score based on VAP patients’ comorbidities, systolic blood pressure, presence of bacteremia and occurrence of acute respiratory distress syndrome (ARDs), VAP-PIRO accurately predicted the severity and risk of mortality in patients with the condition and determined the extent of healthcare resources needed to care for those patients, according to results of a recent study.

Want more information about VAP? Read the AACN Practice Alert on Ventilator Associated Pneumonia.

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.

Full scholarships to attend NIWI are available for qualified candidates. The deadline to apply is Oct. 13, 2008. Click here for more information and to download a scholarship application.

7. EVIDENCE Internet-based Instruction: An Effective Teaching Tool for Healthcare Professionals (Abstract)
A study led by a team of education researchers published in the Journal of the American Medical Association shows that Internet-based education is an effective way to teach healthcare professionals. The study’s authors reported that Internet-based instruction has unique advantages, including flexible scheduling, adaptability of instruction and readily available content that is easily updated. "As healthcare workers balance challenging practice demands, the ever-expanding volume of medical knowledge requires us to find more effective, efficient ways to learn," the authors noted. "Internet-based instruction will be an important part of the solution."

8. Clinical Practice Resources

PATIENT SAFETY ISSUES

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

NEW EVIDENCE-BASED PRACTICE
A multidisciplinary survey on capillary refill time: Inconsistent performance and interpretation of a common clinical test

Pulse oximeter accuracy and precision affected by sensor location in cyanotic children

Nurse practitioners and physician assistants in the intensive care unit: An evidence-based review.

Alterations in glucose homeostasis in the pediatric intensive care unit: Hyperglycemia and glucose variability are associated with increased mortality and morbidity
*****************************************************************************************
If you do not wish to receive e-mail updates from AACN, please reply to unsubscribe@aacn.org

Do you have a comment, question or story idea for the Critical Care Newsline? Send your email to enewsletter@aacn.org

UPDATE YOUR OWN INFORMATION ONLINE

Did you know you can update your demographic profile, including your e-mail address, online? Simply log in using your membership or customer identification number. Your default password is the first 15 letters of your last name. Go to: http://www.aacn.org/DM/CustomerProfile/UpdateCustomerProfile.aspx

*****************************************************************************************

Your Feedback