Critical Care Newsline — August 12, 2010

 

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 websites that will keep you informed on issues affecting nurses and the nursing profession.
 
August 12, 2010
********************************************
1. CALL TO ACTION Respond to impact of CMS 30-minute rule by Aug. 31
2 NEWS CDC issues health advisory for seasonal influenza A
3 NEWS TJC to revise medication reconciliation guideline
4. EVIDENCE NEJM studies support bystander compression-only CPR
5. NEWS TJC releases patient-communication resource
6. NEWS Register for “What’s New With Beacon?” online presentations, earn CNE credits
7. NEWS TRENDS certification exam deadline, Aug. 13
8. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
9. EVIDENCE HF Registry increases use of recommended therapies
10. CALL TO ACTION Comment on CMS-proposed visitation ruling by Aug. 27
11. CALL TO ACTION Apply for Patient Experience Grant Program by Aug. 31
12. CLINICAL PRACTICE RESOURCES
13. AACN RESOURCES How well do you know AACN? Take our quiz on Facebook.
 
1. CALL TO ACTION Respond to impact of CMS 30-minute rule by Aug. 31
Participate in an Institute for Safe Medication Practices, Horsham, Pa., survey about the 30-minute rule. The Centers for Medicare & Medicaid Services (CMS), Baltimore, requests that surveyors observe this rule to ensure patients receive medications within 30 minutes of their scheduled times. Deadline to participate is Aug. 31.
 
2. NEWS CDC issues health advisory for seasonal influenza A
An Aug. 4 health advisory from the Centers for Disease Control and Prevention (CDC), Atlanta, suggests clinicians use seasonal influenza A (H3N2) infection as a diagnosis to evaluate patients with acute respiratory illness during the summer. The advisory came after increased reports of seasonal influenza A, including two localized outbreaks in non-contiguous counties in Iowa. Because the test has only “moderate sensitivity,” the CDC advises not to rely on a negative rapid influenza diagnostic test result and to not delay treatment pending laboratory confirmation of influenza.
 
3. NEWS TJC to revise medication reconciliation guideline
Following up on its July 27 meeting of the Standards and Survey Procedures Committee, The Joint Commission (TJC), Oakbrook Terrace, Ill., will revise National Patient Safety Goal 8 on medication reconciliation. Many respondents to the field review — who note compliance challenges because of “critical issues beyond the organization’s control” such as “the reliability of patient reporting of current medications” — want to continue to “shine a light” on the issue. The committee will present a revised requirement in October with a target implementation date of July 2011.
 
4. EVIDENCE NEJM studies support bystander compression-only CPR
Two studies in the July 29 New England Journal of Medicine (NEJM) found no difference in patient survival when bystanders received emergency-dispatcher instructions for compression-only versus compression-plus rescue breathing cardiopulmonary resuscitation (CPR). “CPR with Chest Compression Alone or with Rescue Breathing” used survival at hospital discharge as the endpoint, while survival at 30 days was the endpoint for “Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest.”
 
5. NEWS TJC releases patient-communication resource
Access The Joint Commission’s (TJC’s) Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals to read ways to meet patients’ needs and comply with standards for patient-centered communication. The Commonwealth Fund, New York, with the National Health Law Program, Washington, D.C., funded the monograph, which includes practice examples, information on laws and regulations and links to supplemental information, model policies and educational tools.
 
6. NEWS Register for “What’s New With Beacon?” online presentations, earn CNE credits
Register now for the next two free interactive presentations in the “What’s New With Beacon?” online series. Registration limited to first 100 participants. PART 2, “Unit Profile, Process Questions and Scoring,” takes place during the week of Aug. 15, and PART 3, “Patient Outcome Criteria and Scoring,” happens during the week of Sept. 13. Before accessing PART 2 and PART 3, please review PART 1: “What’s New with Beacon?” for maximum learning benefit. This prerecorded online presentation highlights changes to Beacon Award for Excellence criteria to help units align with other national excellence programs. All three presentations, which will be available as archives to view at a later time, offer continuing nursing education (CNE) credits.
 
7. NEWS TRENDS certification exam deadline, Aug. 13
AACN will offer all certification exams at the TRENDS conference in King of Prussia, Pa. — about 20 miles from Philadelphia — the morning of Friday, Oct. 1. Preregister to take an exam by Friday, Aug. 13.
 
8. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
If your facility or chapter has successfully implemented certification best practices — strategies to encourage, recognize and reward certification — in your hospital or unit, submit your story online by Sept. 30. AACN will select the two most innovative practices for panel presentation during the “Creating a Culture of Certification: Best Practices Roundtable” at the 2011 National Teaching Institute & Critical Care Exposition (NTI), April 30-May 5, Chicago. AACN Certification Corporation accepts best-practice submissions, which it posts online, year-round.
 
9. EVIDENCE HF Registry increases use of recommended therapies
A report published online July 26 by Circulation found that participation in a heart failure (HF) registry improved use of five of seven “guideline-recommended” therapies in outpatient cardiology practices. Improvement areas included beta-blockers, aldosterone antagonists, cardiac resynchronization, implantable cardioverter-defibrillator and HF education according to “Improving Evidence-Based Care for Heart Failure in Outpatient Cardiology Practices: Primary Results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF).”

10. CALL TO ACTION Comment on CMS-proposed visitation ruling by Aug. 27
The Centers for Medicare & Medicaid Services (CMS), Baltimore, requests comments by Aug. 27 on a proposed ruling that requires hospitals participating in Medicare and Medicaid programs to have written policies and procedures on patients’ visitation rights. The president’s directive instructed the U.S. Dept. of Health and Human Services, Washington, D.C., to propose that a “participating hospital not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.” It suggests that rule-makers consider allowing participating hospitals to “restrict visitation in medically appropriate circumstances.” Read more in the April 29 Critical Care Newsline.
 
11. CALL TO ACTION Apply for Patient Experience Grant Program by Aug. 31
Apply by Aug. 31 to receive one of four $1,000 Patient Experience Grants from The Beryl Institute, Bedford, Texas. The new grant program supports research to improve the patient care experience.
 
12. CLINICAL PRACTICE RESOURCES
Patient Safety
On Aug. 2, the U.S. Food and Drug Administration, Silver Spring, Md., announced Lundbeck Inc., Deerfield, Ill., has voluntarily recalled two lots of NeoProfen (ibuprofen lysine) Injection — used to close patent ductus arteriosus in premature infants, which may contain particulate matter. Shortages are expected as the company replaces stock.
On Aug. 4, the U.S. Pharmacopeial Convention, Rockville, Md., announced new standardized labeling requirements for injectable medication vials to reduce patient morbidity and mortality from drug errors. Manufacturers can only put cautionary statements for preventing “imminent life-threatening situations” on the top of the medication vial. “For medications in which no cautionary statement is necessary, this area of the vial will be required to remain blank, precluding company logos, company names and other information from being printed in these locations,” the announcement states.
 
 
 
 
 
 
 
 
Evidence
“Blood conservation is safe and effective in reducing transfusions,” states “The Impact of Blood Conservation on Outcomes in Cardiac Surgery: Is It Safe and Effective?” a study of 32,449 patients who underwent coronary bypass surgery. Tolerance of perioperative anemia — a major conservation strategy — doesn’t increase the risk of complications or mortality, according to the report in August’s Annals of Thoracic Surgery.
Predictors of Time to Death After Terminal Withdrawal of Mechanical Ventilation in the ICU,” in August’s CHEST, reports that although time to death varies widely, most patients die within 24 hours after the withdrawal of mechanical ventilation. “Subsequent validation of these predictors may help to inform family counseling at the end of life,” states the study of 1,505 adults in 14 hospitals.
 
 
 
Guidelines
Access “Diagnosis and Evaluation of Chronic Heart Failure (CHF),” the National Guideline Clearinghouse’s, Rockville, Md., a synthesis of guidelines from the European Society of Cardiology, Heart Failure Society of America, National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand and Scottish Intercollegiate Guidelines Network.
 
Resources
The “Hospital Evacuation Decision Guide” and “Hospital Assessment and Recovery Guide” from the “Agency for Healthcare Research Quality,” Rockville, Md., help hospital planners and administrators decide when to evacuate a hospital and when it’s safe to return.
 
13. AACN RESOURCES
How well do you know AACN?
Take our quiz on Facebook.
 
E-Learning
Did you know you can purchase three of our high-quality Web-based courses for your personal development? “The Preceptor Challenge” and the award-winning “Promoting Excellence in Palliative & End-of-Life Care” feature simulations of real-life experiences. If you’re a new manager or just want to expand your management competencies, the “Essentials of Nurse Manager Orientation” course is also available for individual purchase. Access more information and pricing.

‘Stand Tall’ Resources
AACN’s annual theme is a rallying cry that gathers the organization’s mission, vision, core values and strategic direction in a meaningful way. Kristine Peterson, who became AACN president July 1, at the start of AACN’s fiscal year 2011, calls on nurses to “Stand Tall.” This year, AACN introduces Stan Tall, its first theme mascot. Download Stan and learn more. Become Stan’s friend on Facebook.
 
Healthy Work Environment
Access AACN’s Healthy Work Environment tools.

JOIN AACN ONLINE
Like us on Facebook
Follow us on Twitter
Friend Stan Tall on Facebook

******************************************************************************
If you do not wish to receive e-mail updates from AACN, please reply to unsubscribe@aacn.org
Do you have a comment, question or story idea for Critical Care Newsline? Send your e-mail to enewsletter@aacn.org

UPDATE YOUR OWN INFORMATION ONLINE
Did you know you can update your demographic profile, including your e-mail address, online? Simply log in using your membership or customer identification number. Your default password is the first 15 letters of your last name. Go to: http://www.aacn.org/DM/CustomerProfile/UpdateCustomerProfile.aspx

******************************************************************************
Simply log in using your membership or customer identification number. Your default password is the first 15 letters of your last name. Go to: http://www.aacn.org/DM/CustomerProfile/UpdateCustomerProfile.aspx
******************************************************************************
Your Feedback