Critical Care Newsline — May 28, 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.


May 28, 2009

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1. EVIDENCE At the End of Life: Managing Pain in the ICU (Free Full Text)
2. EVIDENCE Do Critical Care Checklists Streamline Approvals in Quality-improvement Research?
3. RESOURCE Free Downloads About Patient Safety
4. CALL FOR RESPONSE Take the Critical Care Nurse Journal Readership Survey
5. CALL FOR COMMENT 2009 National Patient Safety Goals Revisions
6. REMINDER Last Chance to Nominate Candidates for AACN Leadership Positions
7. REMINDER Last Chance to Submit Live Educational Sessions for NTI 2010 in Washington, D.C.
8. Clinical Practice Resources
9. AACN Resources
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1. EVIDENCE At the End of Life: Managing Pain in the ICU (Free Full Text)
Optimal pain management and palliative care in the ICU environment focuses on multiple sources of patients’ pain and targets communication among patients, families and caregivers that promote patient comfort, according to a recent report. The report’s authors indicate such a focused approach to pain management is perhaps one of the most crucial aspects of optimizing delivery of care in the complex critical care setting. “To achieve high-quality pain management and palliative care in the ICU, processes and outcomes of such care need to be evaluated and revised accordingly. With careful attention to palliative care and pain management, patients and their families can avoid suffering while pursuing healing or comfortable dying in the ICU”, the authors noted. The report is part of a series of five papers developed by critical care experts from AACN, the Critical Care Institute of the ACCP and the American Society of Health-System Pharmacists. The article series reviews the complex nature of pain experienced by a critical care patient and details the benefits of taking a comprehensive approach to pain management—one that combines pharmacotherapy with behavioral, social and communication strategies, interdisciplinary teams and family involvement.

Test your knowledge on this topic. Take AACN’s Self Assessment: Palliative and End-of-Life Care.

2. EVIDENCE Do Critical Care Checklists Streamline Approvals in Quality-improvement Research?
Checklists have been recently promulgated as a method to enhance patient safety and improve outcomes for critically ill patients but how effective are they? A recent article highlights the journey of a recent research project from the Johns Hopkins Medical Institutions demonstrating that the addition of checklists to standard care in the ICU is associated with a decrease in the incidence of catheter-related bloodstream infections. This research, initially evaluated at the institutional level, was successfully expanded to the state level as part of the Michigan Keystone Project. Although the work received positive attention in the lay press, the Office for Human Research Protections placed the data on hold because it had not received approval by the Institutional Review Board at the participating hospitals in Michigan and did not contain informed consent from each patient and clinician involved. “This article documents the recent events surrounding the Keystone Project and the response to the actions taken by the Office for Human Research Protections in the lay press and the new media (Internet and blogs), articulates how a determination can be made if a project is quality-improvement, human-subjects research, or both, and proposes some solutions to create a structured approach to this kind of research in the future” the authors noted.

3. RESOURCE Free Downloads About Patient Safety
In honor of Nurses Week earlier this month, The Joint Commission posted important resources to help nurses enhance practices to keep their patients safe. Be sure to check out the PowerPoint presentation, “The Mandate for Patient Safety.”

4. CALL FOR RESPONSE Take the Critical Care Nurse Journal Readership Survey
What do you think of the features we’ve added to Critical Care Nurse in the past year? This survey is your chance to tell us. But hurry! The survey will only be available online until June 15, 2009. To show our appreciation for your time, we're offering a free iPod nano to one randomly chosen respondent.

5. CALL FOR COMMENT 2009 National Patient Safety Goals Revisions
The Joint Commission is revising the 2009 National Patient Safety Goals (NPSGs) to clarify language and make sure that they are relevant to the settings in which they apply: Ambulatory Health Care, Behavioral Health Care, Critical Access Hospitals, Home Care, Hospital, Laboratory, Long Term Care, Office-Based Surgery accreditation programs and The Disease Specific Care Certification program. In addition, the commission is reviewing the 2009 Universal Protocol (UP) for the following areas: Ambulatory Health Care, Critical Access Hospitals, Hospital, and Office-Based Surgery accreditation programs and The Disease Specific Care Certification program. Those responsible for implementing NPSGs and Universal Protocols are invited to review and comment on the proposed revisions. Comments will be accpeted for 6 weeks, beginning May 12, 2009.

6. REMINDER Last Chance to Nominate Candidates for AACN Leadership Positions
Do you know someone who you think would provide strong, effective leadership as a member of the AACN Board of Directors or the AACN Nominating Committee? Review the required competencies in the AACN Framework for Governance Leadership Positions and submit nominations by May 31, 2009.

7. REMINDER Last Chance to Submit Live Educational Sessions for NTI 2010 in Washington, D.C.
AACN is accepting abstracts for live educational sessions to be presented at NTI 2010. Abstracts selected for presentation must reflect AACN’s mission, vision and values; support AACN’s major areas of interest; link research and practice; present cutting edge information and contain precise, comprehensive content. The deadline is June 1, 2009.

8. Clinical Practice Resources

COMPREHENSIVE H1N1 FLU INFORMATION

IDENTIFYING AND TREATING PATIENTS WITH H1N1

EVIDENCE-BASED PRACTICE
Risk Factors for Delirium in Intensive Care Patients: a Prospective Cohort Study

Effect of a Pharmacist on Adverse Drug Events and Medication Errors in Outpatients with Cardiovascular Disease

Cinaciguat (BAY 58-2667) Improves Cardiopulmonary Hemodynamics in Patients With Acute Decompensated Heart Failure

Cardiac Resynchronization Therapy in Pediatric and Congenital Heart Disease: Differential Effects in Various Anatomic and Functional Substrates

GUIDELINES
Recommended Immunization Schedules for Persons Aged 0 Through 18 Years: United States, 2009

PATIENT SAFETY ISSUES
Fun Express Water-based Face Paints for Children-Nationwide recall due to reports of skin reactions in children, rashes, itchiness, burning sensation, and swelling

Respironics SmartMonitor 2 Infant Apnea Monitor-Class I recall issued because the monitors may fail to sound alarm

Digoxin, USP 0.25 mg (AS Medication Solutions/Caraco)-UPDATE: Recall due to variance in amount of active ingredient

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