Critical Care Newsline — August 20, 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 our 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.

Aug. 20, 2009

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1. NEWS “Prevalence and Factors of Intensive Care Unit Conflicts: The Conflicus Study”
2. EVIDENCE Sleep in the ICU: potential mechanisms and clinical implications
3. NEWS The Joint Commission to parents: “Speak Up” to prevent errors in care of children
4. EVIDENCE Violence against emergency department nurses common in U.S.
5. RESEARCH “Lansoprazole, Ranitidine, and Metoclopramide: Comparison of Practice Patterns at 4 Level III NICUs Within One Healthcare System”
6. PATIENT SAFETY Palliative sedation therapy doesn’t hasten death
7. NEWS New Publish Ahead of Print articles for American Journal of Critical Care
8. CLINICAL PRACTICE RESOURCES
9. AACN RESOURCES
10. REMINDERS

1. NEWS “Prevalence and Factors of Intensive Care Unit Conflicts: The Conflicus Study”
Over 70 percent of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain according to a survey of 7,498 clinicians from 323 ICUs in 24 countries in July’s American Journal of Respiratory and Critical Care Medicine. Workload, inadequate communication and end-of-life care emerged as important potential targets for improvement.

2. EVIDENCE Sleep in the ICU: potential mechanisms and clinical implications
This article, published in the July 1 issue of CHEST, reviews the literature describing sleep in ICU patients, including recent investigations in patients who require mechanical ventilation, factors that affect sleep in critically ill patients, and the potential mechanisms and clinical implications of disturbed sleep in the ICU setting with directions to consider for future investigations.

3. NEWS The Joint Commission to parents: “Speak Up” to prevent errors in care of children
“Speak Up,” a new pediatric campaign from The Joint Commission, advises parents to ask questions and get involved in their children’s care to help prevent medical errors. Topics include going to the hospital and having a safe operation. Download free brochures in English and Spanish here

4. EVIDENCE Violence against emergency department nurses common in U.S.
Violence against ED nurses is highly prevalent. Precipitating factors to violent incidents identified by respondents are consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED nurses according to a study in the July/August issue of The Journal of Nursing Administration.

5. RESEARCH “Lansoprazole, Ranitidine, and Metoclopramide: Comparison of Practice Patterns at 4 Level III NICUs Within One Healthcare System”
Use of lansoprazole, ranitidine and metoclopramide varied considerably in four Level III NICUs at one health system according to a retrospective study published in June’s Advances in Neonatal Care. Researchers called for case-controlled studies or randomized clinical trials to establish evidence to guide practice.

6. PATIENT SAFETY Palliative sedation therapy doesn’t hasten death
Results from a prospective multicenter study indicate that palliative sedation therapy doesn’t shorten life when used to relieve refractory symptoms of cancer patients. For more information, visit the site or link to AACN here.

7. NEWS New Publish Ahead of Print articles for American Journal of Critical Care
This month’s Publish Ahead of Print articles are now live on the American Journal of Critical Care Web site, www.ajcconline.org. Click the OnlineFirst logo to read an evaluation of knowledge by physicians, nurses and respiratory therapists about evidence-based guidelines to prevent ventilator-associated pneumonia and a study comparing iced and room-temperature injectates for thermodilution measurement of cardiac index in postoperative cardiac surgical patients during hypothermia and normothermia. Log-in required to read articles; abstracts have free access.

8. CLINICAL PRACTICE RESOURCES

EVIDENCE-BASED PRACTICE
Negative pressure wound therapy devices: technology assessment report by ECRI Institute and Agency for Healthcare Research and Quality.
(http://www.ahrq.gov/clinic/ta/negpresswtd/)

Nurse-led program reduces depression in stroke survivors
A nurse-led intervention, “Living Well with Stroke” (LWWS), reduced post-stroke depression according to a 2009 study of over 100 stroke survivors. Care for those randomized in the LWWS group included individual counseling sessions with a specially trained stroke rehabilitation nurse and physical activity with or without antidepressants. (http://www.nih.gov/news/health/aug2009/ninr-06.htm)


PATIENT SAFETY

FDA warns of inaccuracies with GDH-PQQ glucose test strips
On Aug. 13, the U.S. Food and Drug Administration alerted healthcare practitioners that GDH-PQQ glucose test strips may indicate a falsely elevated blood glucose level in patients who receive therapeutic products that contain non-glucose sugars or when a product’s metabolic output includes non-glucose sugars. The FDA recommends avoiding GDH-PQQ glucose test strips.


PATIENT SAFETY On the ball: Leadership for patient safety and learning in critical care includes characteristics of patient safety.
http://www.ncbi.nlm.nih.gov/pubmed/19641431

ADVISORY Limited recall of fentanyl transdermal system
On Aug. 7, Watson Pharmaceuticals, Inc., Weston, Fla., recalled one lot (number 145287A) of 100 mcg/hr fentanyl transdermal system patches sold in the U.S. because of leaks that can cause serious adverse events, such as respiratory depression.
http://ir.watson.com/phoenix.zhtml?c=65778&p=irol-newsArticle&ID=1318770

RESOURCE The Joint Commission issues education program to prevent healthcare-associated infections
The Joint Commission released a complimentary education program to help organizations meet its three National Patient Safety Goals to prevent healthcare-associated infections. Organizations must comply with the National Patient Safety Goals by Jan. 1, 2010.

RESOURCE Nurse Advise-ERR
Current and past issues of Nurse Advise-ERR from the Institute for Safe Medication Practices can be accessed at
http://www.ismp.org/Newsletters/nursing/backissues.asp


RESOURCE Workplace Factors and Medication Use
Learn how to create a workplace that optimizes safe medication use by reading “Factors to Consider When Assessing Physical Environment Needs,” published in the November/December 2008 issue of Pharmacopeial Forum. http://www.usp.org/pdf/EN/USPNF/PF34(6)Combined.pdf

9. AACN RESOURCES
For information about AACN’s many resources for acute and critical care nurses, visit www.aacn.org

10. REMINDERS
AACN members can visit www.aacn.org/ce to access free unlimited continuing education (CE) credits, CE certificates, exam registration and personal transcript records. For CCRN and PCCN self-assessment certification exams, visit www.aacn.org/ce

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