Critical Care Newsline — July 23, 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 23, 2009

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1. EVIDENCE Radiofrequency Catheter Ablation to Treat Atrial Fibrillation Produces Mixed Results
2. EVIDENCE Atrial Fibrillation Linked to Increased Hospitalization in Certain Heart Failure Patients
3. EVIDENCE BCMA Reduces Medication Errors in MedSurge Units but Not ICUs
4. NEWS Uninsured Account for Nearly One-fifth of Emergency Room Visits
5. NEWS Web Based CCRN Exam Testing Now Available for Overseas Military Nurses
6. NEWS Going Green: Certification Renewal Handbook No Longer Mailed With Renewal Letters
7. REMINDER AACN Circle of Excellence Awards Nomination Deadline Only a Week Away
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE Radiofrequency Catheter Ablation to Treat Atrial Fibrillation Produces Mixed Results
Although radiofrequency catheter ablation is used to treat atrial fibrillation, little is known about the treatment's long-term benefits and the best methods and circumstances to apply it, according to a new report funded by the Agency for Healthcare Research and Quality (AHRQ). The report found that the procedure may provide benefits in maintaining normal heart rhythm over short periods of time but does not show whether the procedure reduces atrial fibrillation over the long term. Patients with atrial fibrillation are typically treated with medication first but medicines prevent recurrence in only about half of the patients.

2. EVIDENCE Atrial Fibrillation Linked to Increased Hospitalization in Certain Heart Failure Patients
Patients with atrial fibrillation who do not take beta-blockers face a higher risk of hospitalization from heart failure than those who do, according to a new study. Researchers also found that atrial fibrillation does not increase risk of death in heart failure patients, contradicting previous assumptions. “In patients with heart failure and atrial fibrillation, beta-blockers, which help reduce heart rate, may be useful in reducing the risk of hospitalization due to worsening heart failure,” the researchers reported.

3. EVIDENCE BCMA Reduces Medication Errors in Med/Surge Units but Not ICUs
Bar-code–assisted medication administration (BCMA) systems reduce medication errors in medical/surgical wards but not in intensive care units, a recent study reports. Although findings show improvements in patient identification practices, they also indicate an increase in nurse distractions during the administration process. The authors conclude that implementing BCMA systems may have different effects in different patient care areas, although bar coding technology is rapidly being adopted as an effective mechanism to prevent adverse events.

4. NEWS Uninsured Account for Nearly One-fifth of Emergency Room Visits
Uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006, according to data from the Nationwide Emergency Department Sample—the largest, all-payer emergency department database in the United States. The database, managed by the Agency for Healthcare Research and Quality (AHRQ), generates national estimates on the number of emergency department visits in all community hospitals, by region, urban/rural location, teaching status, ownership and trauma designation. "Our healthcare system has forced too many uninsured, rural and low-income Americans to depend on the emergency room for the care they need," says Health and Human Services Department Secretary Kathleen Sebelius. "We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies."

5. NEWS Web Based CCRN Exam Testing Now Available for Overseas Military Nurses
Deployed nurses can now take the adult CCRN exam via Web-based testing at DANTES (military) testing sites. For more information, e-mail katherine.taylor@aacn.org or call (800) 394-5995, ext. 271.

6. NEWS Going Green: Certification Renewal Handbook No Longer Mailed With Renewal Letters
To help the environment and to cut costs, AACN Certification Corporation no longer includes the CCRN/PCCN Renewal Handbook with certificant renewal letters. You can still download the handbook from the Certification Web site or request a printed copy by e-mailing aacninfo@aacn.org.

7. REMINDER AACN Circle of Excellence Awards Nomination Deadline Only a Week Away
Aug. 1 is the deadline to submit nominations for the 2010 Circle of Excellence Awards.
Up to 25 individuals who exemplify excellence in the care of acutely and critically ill patients and their families will be chosen to receive the 2010 awards; recipients will become part of the Circle of Excellence Society. Learn about the awards, review the criteria and fill out a nomination form at www.aacn.org/awards.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Structured Approaches to Pain Management in the ICU

Correlation between the Sedation-Agitation Scale and the Bispectral Index in Ventilated Patients in the Intensive Care Unit

GUIDELINES
Critical Care in Pregnancy

PATIENT SAFETY
Teva Pharmaceuticals USA issues a voluntary user-level nationwide recall of Propofol Injectable Emulsion 10 mg/mL 100 mL vials, lot numbers 31305429B and 31305430B

Recall: Prevnar Pneumococcal 7-valent Conjugate Vaccine, Wyeth

Omalizumab (marketed as Xolair): Early communication about an ongoing safety review

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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