Critical Care Newsline — April 22, 2010

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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.

April 22, 2010

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1. CALL TO ACTION AACN 2010 election, voting closes Monday
2. NEWS New IOM summary reports key challenges in acute care nursing
3. EVIDENCE Aspirin on par with dual antiplatelet therapy in patients with drug-eluting stents
4. NEWS AACN endorses INS position on intraosseous access
5. JOIN THE DISCUSSION Nurses’ role expands amid doctor shortages
6. CALL TO ACTION Comment on TJC’s proposed National Patient Safety Goal
7. CLINICAL PRACTICE RESOURCES
8. AACN RESOURCES AACN Protocols for Practice price reductions

1. CALL TO ACTION AACN 2010 election, voting closes Monday
Time is running out to cast your ballot. Don’t miss this opportunity to have a voice in selecting the next leaders of AACN. You will need your member number to vote. Voting closes April 26 at 11:59 p.m. Eastern time. Vote now.

2. NEWS New IOM summary reports key challenges in acute care nursing
On April 14, the Institute of Medicine (IOM) released “A Summary of the October 2009 Forum on the Future of Nursing: Acute Care,” held in Los Angeles. At this first of three forums for the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, participants discussed quality, safety, technology and interdisciplinary collaboration in acute care. Carol Hartigan, certification programs strategist, and Robi Hellman, clinical practice manager, represented AACN at the forum of more than 300 participants. Access the meeting’s webcast and speaker materials.

3. EVIDENCE Aspirin on par with dual antiplatelet therapy in patients with drug-eluting stents
The use of dual antiplatelet therapy for longer than one year in patients who receive drug-eluting stents is “not significantly more effective than aspirin monotherapy in reducing the rate of myocardial infarction or death from cardiac causes,” finds a study in April 15’s New England Journal of Medicine. “Duration of Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents” randomly assigned 2,701 patients with drug-eluting stents “who had been free of major adverse cardiac or cerebrovascular events and major bleeding” for at least 12 months to receive “clopidogrel plus aspirin or aspirin alone.”

4. NEWS AACN endorses INS position on intraosseous access
On April 22, AACN endorsed the Infusion Nurses Society’s (INS’s) position paper “The Role of the Registered Nurse in the Insertion of Intraosseous (IO) Access Devices,” which states an RN, “who is proficient in infusion therapy and who has been appropriately trained for the procedure, may insert, maintain, and remove intraosseous access devices.”

5. JOIN THE DISCUSSION Nurses’ role expands amid doctor shortages
Doctor Shortage? 28 States May Expand Nurses’ Role,” an Associated Press article published online April 13, states that research supports the use of nurse practitioners to help solve the primary care physician shortage. What do you think? Read the article and join the discussion on AACN’s page on Facebook.

6. CALL TO ACTION Comment on TJC’s proposed National Patient Safety Goal
The Joint Commission (TJC), Oakbrook Terrace, Ill., requests comments on proposed revisions to the Medication Reconciliation National Patient Safety Goal, which highlights specific risk points that are critical and readily achievable.

7. CLINICAL PRACTICE RESOURCES
Patient Safety
U.S. Food and Drug Administration (FDA), Silver Spring, Md., approved a new formulation of OxyContin, manufactured by Purdue Pharma L.P., Stamford, Conn., designed to help deter abuse of the opioid by preventing it from being cut, chewed, crushed or dissolved to release more medication. Read the April 5 announcement.

FDA again warned clinicians to use their professional judgment in determining heparin dosing after laboratory studies found that heparin sodium made under the new United States Pharmacopeia (USP) Monograph, “new heparin,” has about 10 percent less anticoagulant activity compared to heparin made using the previous, “old,” USP Monograph. Read the April 7 announcement.

April’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices, Horsham, Pa., stresses to never use parenteral syringes to prepare and administer oral liquid products and provides strategies to promote consistent use of oral syringes.

Guidelines Just released from National Guideline Clearinghouse
Access a summary of the “Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents,” issued in 2009by the American Academy of Pediatric Dentistry, Chicago, or download the complete guidelines.

Access a summary of “AASLD Practice Guidelines: The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Management of Portal Hypertension,” published in January’s Hepatology by the American Association for the Study of Liver Disease, Alexandria, Va.

Resources
Download “Coordinating Pediatric Medical Care During an Influenza Epidemic,” a free workbook to help hospitals coordinate care for children with flu-like illness during a flu pandemic, from the Centers for Disease Control and Prevention, Atlanta.

8. AACN RESOURCES
AACN Protocols for Practice price reductions
Several AACN Protocols for Practice are available at a fraction of their original price in the AACN Online Bookstore. The list includes “Palliative Care and End-of-Life Issues in Critical Care,” “Non-Invasive Monitoring, 2nd Ed.,” “Creating Healing Environments, 2nd Ed.,” “Care of the Mechanically Ventilated Patient, 2nd Ed.” and “Monitoring Technologies in Critically Ill Neuroscience Patients.”

E-Learning
AACN offers individual nurses access to two of its most popular Web-based courses, “The Preceptor Challenge” and double-award-winning “Promoting Excellence in Palliative & End-of-Life Care.” Nurses may purchase six-month access to “The Preceptor Challenge” for $100 and “Promoting Excellence in Palliative & End-of-Life Care” for $50 at the AACN LearnCenter. “The Preceptor Challenge,” a three-module course, uses virtual tools to enable nurses to identify best practices. The groundbreaking “Promoting Excellence in Palliative & End-of-Life Care” allows nurses to apply theory-based practice without the risk of harm to patients or families.

Healthy Work Environment
Access the AACN Healthy Work Environment Assessment, a free Web-based tool to help nurse managers and leaders align hospital unit performance with the AACN Standards for Establishing and Sustaining Healthy Work Environments (HWEs). The online tool — developed with VitalSmarts, a provider of corporate training and organizational performance products and services in Provo, Utah — aligns the performance of any clinical environment, from single hospital units to entire healthcare organizations, with the six HWE standards. They include skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership.

Access a recording of the live webinar “Assessing the Health of Your Work Environment.” Available on the AACN Web site, the webinar — a joint venture between AACN and VitalSmarts, Provo, Utah — promises to be of particular interest to users of the AACN Healthy Work Environment Assessment, a Web-based tool that aligns any clinical environment with the six HWE standards. NOTE: Video portion of recording loads slowly.

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