Critical Care Newsline — March 5, 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.

March 5, 2009

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1. CALL FOR RESPONSE AACN Critical Care Newsline Readership Survey
2. EVIDENCE Safe or Suspect? Chronic Opioid Therapy for Chronic Non-cancer Pain (Free Full Text)
3. NEWS OnlineFirst "Publish Ahead of Print" Feature Now Available on AJCC Web Site
4. REMINDER Have You Registered for NTI 2009 in New Orleans?
5. NEWS NQF Endorses Guidelines for Culturally Appropriate Care
6. EVIDENCE Crucial Conversations Dash Disruptive Behavior
7. REMINDER April 1 Is Application Deadline for NTI Paper and Pencil Certification Exam
8. Clinical Practice Resources
9. AACN Resources
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1. CALL FOR RESPONSE AACN Critical Care Newsline Readership Survey
What do you like about Critical Care Newsline, AACN’s weekly e-newsletter? What would you change if you could? Your opinions are important to us. Please take a few minutes to complete the 2009 Critical Care Newsline readership survey. The results will be used to develop content for future issues and to ensure that the newsletter meets your needs. The deadline to respond is March 27, 2009.

2. EVIDENCE Safe or Suspect? Chronic Opioid Therapy for Chronic Non-cancer Pain (Free Full Text)
Opioid pain medications are safe and effective for carefully selected, well-monitored patients with chronic non-cancer pain, according to guidelines released by a national panel of pain management experts from the American Pain Society and the American Academy of Pain Medicine. Opioid prescribing has increased significantly due to growing professional acceptance that the drugs can relieve chronic non-cancer pain, and the guidelines acknowledge widespread concerns about increases in prescription opioid abuse, addiction and diversion. "This guideline was a true multidisciplinary effort that sought to address in a balanced manner the many challenging issues that clinicians face with regard to when and how to prescribe opioids for chronic non-cancer pain," the authors noted, adding that patients should be given a thorough medical history and examination to assess their potential risk for substance abuse, misuse or addiction before treatment with opioids.

3. NEWS OnlineFirst "Publish Ahead of Print" Feature Now Available on AJCC Web Site
Select articles from the American Journal of Critical Care are now available at AJCC online before they appear in print. This month, read about an early mobility and walking program for ICU patients, monitoring multidrug-resistant organisms, and a new model of critical care orientation. Log-in is required. To be notified whenever new OnlineFirst articles are posted, register your e-mail address on the AJCC Web site by clicking "Email alerts" from the home page.

4. REMINDER Have You Registered for NTI 2009 in New Orleans?
With the click of a mouse, you can sign up to attend NTI sessions, exhibits and events; book your hotel; and download the conference brochure. Save money, too, if you register by April 1.

5. NEWS NQF Endorses Guidelines for Culturally Appropriate Care
The National Quality Forum (NQF) recently endorsed 45 practices to help healthcare systems provide culturally appropriate and patient-centered care: they include specific approaches to leadership, care delivery, workforce training, communication, data collection and community engagement. A Disparities Toolkit helps providers collect accurate information on race, ethnicity and primary language to reduce disparities and improve quality of care.

6. EVIDENCE Crucial Conversations Dash Disruptive Behavior
Healthcare leaders who want to engage social influence to eliminate disruptive behavior will have to break the code of silence in four crucial conversations, according to a recently published article. “The Joint Commission recently announced that rude language and hostile behavior pose serious threats to patient safety and quality of care. But while these disruptive and disrespectful behaviors can be hurtful, what prompted The Joint Commission to address them as a condition of accreditation is the mounting evidence that these behaviors are also harmful,” according to the article’s author, who added that the Silence Kills study conducted by AACN and VitalSmarts found that more than 20% of healthcare professionals have seen actual harm come to patients as a result of such behavior. “To secure patients’ well-being and increase employee retention and engagement, the most immediate and effective thing healthcare leaders can do is to change the culture of silence,” the author concluded.

Download the entire Silence Kills study or the Executive Summary. You can also link to The Joint Commission Sentinel Event Alert.

7. REMINDER April 1 Is Application Deadline for NTI Paper and Pencil Certification Exam
Paper and pencil administration of the CCRN, PCCN, CCNS, ACNPC and CNML specialty exams, and the CMC (Cardiac Medicine) and CSC (Cardiac Surgery) subspecialty exams will take place May 18 at NTI 2009 in New Orleans. If you are interested in taking any of these certification exams, please download the special NTI exam application and submit your completed application with fee payment to AACN. Your submission must be postmarked by April 1, 2009.

8. Clinical Practice Resources

EVIDENCE-BASED PRACTICE
Delirium and Sedation in the Intensive Care Unit: Survey of Behaviors and Attitudes of 1384 Healthcare Professionals

Pharmacokinetic Issues for Antibiotics in the Critically Ill Patient

Deciding in the Dark: Advance Directives and Continuation of Treatment in Chronic Critical Illness

Developing Guidelines That Identify Patients Who Would Benefit From Palliative Care Services in the Surgical Intensive Care Unit

(For more on this topic, refer to AACN’s Palliative and End-of-life Care Self-Assessment Tool.)

Scientific Evidence Underlying the ACC/AHA Clinical Practice Guidelines

GUIDELINES

The following are from the American College of Chest Physicians Evidence-based Clinical Practice Guidelines (8th edition):

Prevention of Venous Thromboembolism

Antithrombotic Therapy for Venous Thromboembolic Disease

Treatment and Prevention of Heparin-induced Thrombocytopenia

PATIENT SAFETY ISSUES
Metoclopramide-containing Drugs: Chronic Use Linked to Tardive Dyskinesia


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