Critical Care Newsline — November 12, 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.

Nov. 12, 2009

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1. NEWS U.S. House of Representatives passes historic health reform legislation
2. CALL TO ACTION Distinguished Research Lectureship
3. AACN RESOURCE Access comprehensive H1N1 information on AACN Web site
4. RESEARCH Best practices program reduces medication errors
5. EVIDENCE Remote monitoring improves outcomes in patients with chronic heart failure
6. HEALTHY WORK ENVIRONMENT Nurse-physician executive survey shows bad behavior common
7. EVIDENCE Late ICU admission increases risks for patients with community-acquired pneumonia
8. RESEARCH Intermittent hemodialysis effective for most cardiac surgery patients
9. EVIDENCE Inappropriate antimicrobial therapy in septic shock reduces survival rates fivefold
10. RESEARCH Physicians reluctant to admit patients 80 years or older to ICU
11. CLINICAL PRACTICE RESOURCES

1. NEWS U.S. House of Representatives passes health reform legislation
On Nov. 7, the U.S. House of Representatives passed historic health reform legislation, the first of four pivotal votes before it can reach the desk of President Obama. Next, the Senate votes on its legislation. Then, each chamber of Congress will vote again on a reconciled bill. See how representatives voted. Use AACN’s online Legislative Action Center, to contact your representative and express your thanks or disappointment.

2. CALL TO ACTION Distinguished Research Lectureship
Nominate your colleagues for the 2011 AACN Distinguished Research Lectureship. Deadline, Dec. 1.

3. AACN RESOURCE Access comprehensive H1N1 information on AACN Web site
Access the comprehensive H1N1 Influenza Resource Center.

4. RESEARCH Best practices program reduces medication errors
A program of six best practices conducted at the University of California, San Francisco, reduced medication errors at nine hospitals by 88 percent reports the Integrated Nurse Leadership Program. Results will be published in December’s The Joint Commission Journal on Quality and Patient Safety. Read more.

5. EVIDENCE Remote monitoring improves outcomes in patients with chronic heart failure
Remote patient monitoring decreased mortality and hospitalization according to a meta-analysis of more than 8,000 patients with chronic heart failure from 20 randomized controlled clinical trials and 12 cohort studies in Oct. 27’s Journal of American Cardiology.

6. HEALTHY WORK ENVIRONMENT Nurse-physician executive survey shows bad behavior common
A survey of more than 2,100 nurse and physician executives by the American College of Physician Executives, Tampa, Fla., indicates that nearly 98 percent witnessed behavior problems in the last year between nurses and physicians, with degrading comments and insults the most common. Read Special Report: 2009 Doctor-Nurse Behavior Survey, which includes several other articles related to disruptive behavior, and participate in an online discussion.

7. EVIDENCE Late ICU admission increases risks for patients with community-acquired pneumonia
Patients with severe community-acquired pneumonia admitted to the ICU within 24 hours show a lower 30-day mortality than those admitted “late,” 48 hours or more, states a retrospective study of 161 ICU patients in October’s CHEST.

8. RESEARCH Intermittent hemodialysis effective for most cardiac surgery patients
Most patients dependent on hemodialysis, who undergo cardiac surgery, can be managed with intermittent rather than continuous venovenous hemodiafiltration according to a retrospective study of 245 patients in November’s Annals of Thoracic Surgery.

9. EVIDENCE Inappropriate antimicrobial therapy in septic shock reduces survival rates fivefold
About 20 percent of patients experience inappropriate antimicrobial therapy for septic shock, which reduces survival rates fivefold according to a study of 5,175 patients in three countries appearing in November’s CHEST.

10. RESEARCH Physicians reluctant to admit patients 80 years or older to ICU
Even when indicated and/or appropriate, emergency department and ICU physicians in 15 French hospitals showed reluctance to admit patients 80 years or older to the ICU, says a prospective study of 2,646 patients in November’s Critical Care Medicine.

11. CLINICAL PRACTICE RESOURCES
PATIENT SAFETY
On Oct. 28, Pointe Scientific, manufacturer of clinical diagnostic products, Canton, Mich., and the U.S. Food and Drug Administration announced a recall of liquid glucose hexokinase reagent (catalog number G7517) because of inaccurate readings above 200 mg/dL. Learn more.

On Oct. 23, Cordis, Bridgewater N.J., announced a voluntary recall of all CROSSOVER Sheath Introducers used during arterial and venous procedures because of stretching or fracture of the sheath during use. Learn more.

RESEARCH
Percutaneous ventricular assist devices (VADs), reliable bridge-to-transplant devices, allow more time for complete evaluations without the added expense and morbidity of long-term VADs according to November’s Annals of Thoracic Surgery.

Patients with inferior vena cava filters can be managed effectively with anticoagulant therapy that uses clinical and ultrasound monitoring and treats clots at the filter site with “graded intensities of anticoagulation” states a prospective study in November’s CHEST.

RESOURCE
On Nov. 4, the U.S. Food and Drug Administration, Silver Spring, Md., announced the Safe Use Initiative, a public/private collaborative effort to reduce harm related to medication use.

REVIEW
Critical Care published a health technology assessment review of computerized glucose regulation in the ICU. Read the article, published Oct. 16 online.

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