Critical Care Newsline — July 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 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.


July 2, 2009


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1. EVIDENCE Interpreting Pilot Studies in ICUs Worldwide (Free Full Text)
2. RESOURCE Enteral Nutrition Practice Recommendations
3. RESOURCE Seasonal Influenza Vaccination Strategies
4. EVIDENCE Influenza Immunization Rates for Asthma Sufferers Miss the Mark
5. RESOURCE Anesthesia Web Site for Patients
6. RESOURCE Hand Hygiene Guide
7. REMINDER Submit Nominations for the Circle of Excellence Awards; Deadline Is Aug. 1
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE Interpreting Pilot Studies in ICUs Worldwide (Free Full Text)
Are pilot studies conducted in ICUs around the globe relevant to evidence-based practice in the U.S.? The editors of the American Journal of Critical Care tackle this topic in “All ICUs Are Not Created Equal: Evaluating Pilot Studies Performed in Different Environments.” The authors noted “much credit should be given to the investigators for their creativity, attention to detail and organizational skills. However, there may be times when, for the purpose of making comparisons between intensive care units (ICUs), we need to evaluate more ‘structure’ to understand what made the work possible.” In order to apply the practices to an individual ICU, the editors concluded “one must be privy to certain pieces of information. For starters, we may need to ask what we know about the pilot study hospital’s ICU structure. Often pilot study manuscripts provide insufficient detail about the ICU’s structure and organization, leaving the reader feeling tentative or doubtful about trying that intervention in his or her own ICU. “

2. RESOURCE Enteral Nutrition Practice Recommendations
The American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.) recently released practice guidelines to advance the science and practice of nutrition support therapy. The recommendations are designed for multidisciplinary teams that deliver enteral nutrition in an effort to optimize EN practices. Those who may benefit from the guidelines include clinicians, administrators, educators and researchers; the healthcare community; patients and their caregivers.

3. RESOURCE Seasonal Influenza Vaccination Strategies
The Joint Commission has released a monograph to help healthcare organizations improve seasonal influenza vaccination rates in healthcare personnel. The resource highlights information from Strategies for Implementing Successful Influenza Immunization Programs for Health Care Personnel Project, a collaboration with leading infection prevention and control professional organizations. It also features an overview of evidence-based guidelines, published research studies, legislative and regulatory efforts and accreditation considerations related to improving seasonal influenza vaccination rates in health care personnel.

4. EVIDENCE Influenza Immunization Rates for Asthma Sufferers Miss the Mark
Adults and children with asthma should be vaccinated for seasonal flu because of their risk of complications from the virus, U.S. health officials reported in a recent study. The CDC investigators who conducted the study determined that the vaccination levels among asthma sufferers falls well short of the guideline: at least 60 percent of adults ages 18-64 with asthma should be vaccinated for seasonal influenza. Vaccination is one of several "key clinical activities that should be considered as essential for quality asthma care," the researchers noted. Healthcare providers should also be encouraged to use evidence-based immunization strategies -- such as standing orders, patient reminder/recall, provider reminder, provider assessment and feedback -- for asthma or other high-risk conditions and routinely offer influenza vaccination.

5. RESOURCE Anesthesia Web Site for Patients
The American Society of Anesthesiologists launched a new Web site to serve as a resource for patients. The site, Lifeline to Modern Medicine, provides information about anesthesia care and how patients can help prepare when they are undergoing medical procedures. The site includes information about different types of anesthesia, what to expect before and after surgeries, and information about relevant medical specialties. Patients can also download a checklist to record their medical history, medications and allergies so they will have it on hand in case of surgery.

6. RESOURCE Hand Hygiene Guide
The World Health Organization (WHO) has published a guide on hand hygiene guide to provide healthcare workers with specific recommendations on hand washing, to improve practice and reduce transmission of pathogens to patients and other healthcare workers. More details are available in the Hand Hygiene Improvement and Implementation Toolkit.

7. REMINDER Submit Nominations for the Circle of Excellence Awards; Deadline Is Aug. 1
AACN’s Circle of Excellence Awards program will recognize up to 25 individuals who exemplify excellence in the care of acutely and critically ill patients and their families each year. Guidelines for the program, nomination forms and evaluation criteria are posted on AACN’s Web site. Submit your nomination no later than Aug. 1, 2009 for the 2010 awards.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control
and Exacerbations

Efficacy and Safety of Tissue Plasminogen Activator 3 to 4.5 Hours After Acute Ischemic Stroke: A Metaanalysis

Cerebrospinal Fluid Drainage During Thoracic Aortic Repair: Safety and Current Management

PATIENT SAFETY
Arginine Hydrochloride Injection (Marketed as R-Gene 10): Fatal Medication Errors in a Pediatric Population

Patient Safety Links:

Joint Commission
Medline Plus
National Patient Safety Foundation
Institute for Safe Medication Practices Newsletter
AHRQ Patient Safety Network

9. AACN Resources
For information about AACN's many resources for acute and critical care nurses, click here.

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Reminders:

Visit AACN’s Online CE Center – AACN Members Get Unlimited Free CE Credits
Online Certification Exam Registration Available

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