Critical Care Newsline — April 2, 2009

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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.

April 2, 2009

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1. EVIDENCE Antibacterial Substance Reduces Risk of Catheter-Related Infections (Free Full Text)
2. EVIDENCE Extensive Patient Sharing Among Hospitals Could Impact Spread of Infectious Diseases
3. RESOURCE Flu Fighters: Clinical Practice Guidelines From the Infectious Diseases Society of America
4. RESOURCE National Quality Forum (NQF) Releases Revised Safe Practices Guide
5. RESOURCE AHRQ Releases Hospital Preparedness Tool for Pediatric Patients
6. RESOURCE ACCM Releases Guideline on Pediatric Septic Shock (Free Full Text)
7. NEWS AACN Certification Corporation Revised PCCN Self-Assessment Exam (SAE) Now Available
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE Antibacterial Substance Reduces Risk of Catheter-Related Infections
Use of a sponge containing the antimicrobial agent chlorhexidine gluconate as part of the dressing for ICU patients’ catheters reduced the risk of major catheter-related infections by 61 percent, according to a recent study. The study’s researchers also found that reducing the frequency of changing unsoiled dressings from every three days to seven days appears to be safe. Approximately 80,000 CVC-related bloodstream infections occur each year in ICU patients. The mortality rate from CVC-related bloodstream infections ranges as high as 11.5 percent annually, and the additional ICU length of stay resulting from these infections is estimated at 9 to 12 days.

2. EVIDENCE Extensive Patient Sharing Among Hospitals Could Impact Spread of Infectious Diseases
Findings from the first in-depth study of patient sharing show that hospitals share large numbers of patients with other acute care facilities without knowing it. In a study released at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA), researchers found that only one in nine shared patients is directly transferred from one hospital to another; most patients were discharged before being readmitted to another hospital. This high underestimation of patient sharing has important implications for handling the potential spread of infectious disease among acute care facilities, since patient sharing could be an avenue of transmission if a major disease outbreak were to occur.

3. RESOURCE Flu Fighters: Clinical Practice Guidelines From the Infectious Diseases Society of America
Practitioners may benefit from the new guidelines for the treatment of persons with influenza virus infection prepared by the Infectious Diseases Society of America. The evidence-based plan encompasses diagnosis, treatment and chemoprophylaxis with antiviral medications, and contains information related to institutional outbreak management of seasonal influenza.

4. RESOURCE National Quality Forum (NQF) Releases Revised Safe Practices Guide
NQF’s updated safe practices guide reflects new evidence-based practices and expands on implementation approaches. Practice additions include preventing multidrug-resistant organisms, catheter-associated urinary tract Infections and patient falls, and with care of the caregiver, organ donation, glycemic control and pediatric imaging.

5. RESOURCE AHRQ Releases Hospital Preparedness Tool for Pediatric Patients
The Agency for Healthcare Research and Quality recently released a tool to help hospitals care for large numbers of critically ill children in a public health emergency. The document covers topics such as surge capacity, communications, staff responsibilities, triage, stress management and security concerns when handling children with communicable illnesses.

6. RESOURCE ACCM Releases Guideline on Pediatric Septic Shock (Free Full Text)
The American College of Critical Care Medicine (ACCM) has released a new guideline, "Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock," which updates information found in the 2002 guideline. It emphasizes early use of age-specific therapies to attain time-sensitive goals. The revised version continues to recognize an increased likelihood that children with septic shock, compared with adults, require proportionally larger quantities of fluid, inotrope and vasodilator therapies, hydrocortisone for absolute adrenal insufficiency and extracorporeal membrane oxygenation for refractory shock.

7. NEWS AACN Certification Corporation Revised PCCN Self-Assessment Exam (SAE) Now Available
A newly revised PCCN-Self-Assessment Practice Exam, based on the updated PCCN Test Plan, is available for purchase online for $45. This practice exam is designed as a study tool for PCCN candidates who plan to test after May 2009. The SAE is designed according to the new PCCN test plan, and automatically provides rationale for correct and incorrect answers.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
National Survey of Patients’ Bill of Rights Statutes

Developing a Team Performance Framework for the Intensive Care Unit

GUIDELINES
Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines (Free Full Text)

PATIENT SAFETY ISSUES
Medtronic Innervision Snap Shunt Ventricular Catheter, BioGlide and Snap Shunt Ventricular Catheter, BioGlide - Class I Recall

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