Critical Care Newsline — October 29, 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.

Oct. 29, 2009

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1. NEWS President Obama declares national emergency for H1N1 flu
2. NEWS Study finds frequent conflicts in ICUs
3. RESEARCH Chlorhexidine reduces early ventilator-associated pneumonia according to study
4. NEWS AACN issues new CCRN test plans
5. PATIENT SAFETY FDA and American Regent recommend test dose of iron dextran injection
6. RECALL American Regent recalls ketorolac tromethamine 30 mg/mL injection
7. NEWS FDA issues a warning about unapproved H1N1 products sold online
8. RESEARCH Higher-intensity continuous renal-replacement therapy doesn’t reduce mortality in critically ill patients with acute kidney injury
9. CLINICAL PRACTICE RESOURCES
10. AACN RESOURCES
11. REMINDER

1. NEWS President Obama declares national emergency for H1N1 flu
On Oct. 25, President Obama declared a national emergency in response to the H1N1 flu pandemic to allow Health and Human Services, Washington, D.C., to waive or modify Medicare, Medicaid and Children’s Health Insurance Programs that restrict the ability of healthcare providers to implement disaster plans. The emergency declaration allows hospitals to request waivers for alternative patient screening locations and transferring patients between emergency departments. It also lifts restrictions on bed limits and average patient stays for critical access hospitals. Read more.

2. NEWS Study finds frequent conflicts in ICUs
More than 70 percent of ICU workers experience conflicts (more than half of them severe) with nurse-physician conflicts most common according to a study in November’s American Journal of Respiratory and Critical Care Medicine. Potential causes include heavy workloads, inadequate communication and recent provision of end-of-life care. Read more.

3. RESEARCH Chlorhexidine reduces early ventilator-associated pneumonia
Chlorhexidine reduces early ventilator-associated pneumonia according to a study of 547 ICU patients in September’s American Journal of Critical Care. Read more.

4. NEWS AACN issues new CCRN test plans
AACN will implement new criteria for the CCRN test plans on Jan. 13, 2010. Download new CCRN adult, pediatric and neonatal test plans.

5. PATIENT SAFETY FDA and American Regent recommend test dose of iron dextran injection
To prevent anaphylactic reactions, American Regent, Shirley, N.Y., and the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced a modified box warning for iron dextran injection (Dexferrum) on Oct. 16. The warning recommends first a test then a therapeutic dose. Dexferrum can cause fatal reactions with or without a test dose. Read more.

6. RECALL American Regent recalls ketorolac tromethamine 30 mg/mL injection
On Oct. 21, American Regent announced a voluntary recall of all lots of ketorolac tromethamine 30 mg/mL injection because of potential particulate matter with crystallization in the vials. The recall doesn’t pertain to other concentrations of the drug. To access lot numbers, visit the Web site.

7. NEWS FDA issues a warning about unapproved H1N1 products sold online
On Oct. 15, the U.S. Food and Drug Administration warned consumers to use “extreme care” when purchasing H1N1 drugs online. Potential counterfeits include non-FDA-approved drugs. The FDA also found that products didn’t arrive in time to treat patients infected with the H1N1 virus. Read more. A letter from the FDA and Federal Trade Commission about fraudulent H1N1 flu supplements can be found here.

8. RESEARCH Higher-intensity continuous renal-replacement therapy doesn’t reduce mortality in critically ill patients with acute kidney injury
Higher-intensity continuous renal-replacement therapy (CRRT) didn’t reduce 90-day mortality in critically ill patients with acute kidney injury according to a randomized study of 1,508 patients in Oct. 22’s New England Journal of Medicine. The study compared higher- and lower-intensity CRRT and can be read here.

9. CLINICAL PRACTICE RESOURCES
RESOURCE
Download the 25th edition of “Essential Nursing Resources,” including links to Web sites and other resources, at the Web site.

RESOURCE
A new U.S. Food and Drug Administration Web site tells consumers how to dispose of certain drugs and can be accessed here.

EVIDENCE
The Oct. 12 issue of Critical Care Medicine includes a primer about acute kidney injury treatment in ICU patients. Read the abstract of the primer, based on a PubMed literature review.

PATIENT SAFETY
Download October’s NurseAdvise-ERR from the Institute for Safe Medication Practices. Topics include beware of basal opioid infusions with PCA therapy, too much HYDROmorphone and a fatal sound-alike episode with naloxone and lanoxin.

PATIENT SAFETY
The U.S. Food and Drug Administration will investigate reports made by Hospira, Inc., Lake Forest, Ill., and Abbott Nutrition, Columbus, Ohio, that AC medical device power cords caused sparking, charring and fires. The FDA, which received 122 complaints, recommends device users closely monitor wear and tear on electrical cords. Read more.

RESEARCH
Consensus criteria for transfusion-related acute lung injury can’t be applied to patients undergoing cardiac surgery according to a study of 16,847 cardiac surgery patients in November’s Annals of Thoracic Surgery. Read more.

10. AACN RESOURCES
This month’s Publish Ahead of Print articles are now live on the American Journal of Critical Care Web site, www.ajcconline.org. Click the OnlineFirst logo to read a validation of a dysphagia screening tool for acute stroke patients and the case of a 35-year-old woman who overdosed on cardiac glycosides and was treated with Fab antibody fragments. Member log-in required to read articles; abstracts are free access. Please make sure to include the TITLE and URL within the text hyperlink to www.ajcconline.org.

AACN will offer 15 scholarships for the Nurse in Washington Internship (NIWI). Visit Capitol Hill and make your voice heard by participating in the preeminent program for nurses who want to learn to work with legislators to advance policies and agendas. NIWI takes place Sunday, March 14 through Tuesday, March 16, 2010, in Washington, D.C. Apply at www.aacn.org/niwi. Application deadline is Nov. 1.

11. REMINDER
Access AACN certification news.


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