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Critical Care Newsline — August 19, 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 19, 2010
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1. NEWS Submit poster abstracts for NTI by Sept. 15
2. NEWS Submit proposals for AACN grants in September
3. FACEBOOK DISCUSSION What do you think about hospitals not hiring smokers?
4. EVIDENCE Reminders and stop orders decrease CAUTIs
5. EVIDENCE Two models best predict prolonged ICU stay
6. EVIDENCE New risk model helps predict need for IABP in CABG
7. EVIDENCE Rates of local complications from pediatric CAP rising
8. CALL TO ACTION Submit methods for preventing SSI to TJC by Sept. 5
9. CALL TO ACTION Give TJC feedback on Universal Protocol by Sept. 10
10. CALL TO ACTION Respond to impact of CMS 30-minute rule by Aug. 31
11. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
12. CALL TO ACTION Comment on CMS-proposed visitation ruling by Aug. 27
13. CLINICAL PRACTICE RESOURCES
14. AACN RESOURCES Learn at home with E-Learning
 
1. NEWS Submit poster abstracts for NTI by Sept. 15
Submit poster abstracts for the 2011 National Teaching Institute & Critical Care Exposition (NTI), April 30-May 5, Chicago, in three categories: Research, Evidence-based Solutions, which replaces Creative Solutions, and Chapter Best Practice. Read Poster Abstract Submission Guidelines before submitting your abstract online. Deadline Sept. 15.
 
2. NEWS Submit proposals for AACN grants in September
Submit proposals for AACN 2011 grants from Sept. 1-30. New this year is the AACN Impact Research Grant, which is designed to support experienced clinicians and researchers in inquiry and systematic research, generating new knowledge.
 
3. FACEBOOK DISCUSSION What do you think about hospitals not hiring smokers?
CNN recently reported that as of July 1, a suburban Atlanta hospital will not hire employees who smoke. It’s not the first. What do you think about hospitals not hiring smokers? Join the discussion at facebook.com/aacnface.
 
4. EVIDENCE Reminders and stop orders decrease CAUTIs
Reminders and stop orders for urinary catheters reduce catheter-associated urinary tract infections (CAUTIs), according to “Systematic Review and Meta-Analysis: Reminder Systems to Reduce Catheter-Associated Urinary Tract Infections and Urinary Catheter Use in Hospitalized Patients” in September’s Clinical Infectious Diseases. Such strategies “should be strongly considered to enhance the safety of hospitalized patients,” the study states.
 
5. EVIDENCE Two models best predict prolonged ICU stay
According to “Prediction Models for Prolonged Intensive Care Unit Stay After Cardiac Surgery: Systematic Review and Validation Study,” published online Aug. 2 by Circulation, the Parsonnet model — followed by the European System for Cardiac Operative Risk Evaluation (EuroSCORE) — best predicts prolonged ICU stay in patients who undergo general cardiac surgery.
 
6. EVIDENCE New risk model helps predict need for IABP in CABG
August’s Annals of Thoracic Surgery reports that a simple scoring risk model based on preoperative clinical data can help identify high-risk patients who could benefit from elective insertion of an intraaortic balloon pump (IABP) during coronary artery bypass graft (CABG) surgery. Independent risk factors, cited by the study, include patients older than 70 years, with moderate and poor left ventricular dysfunction, previous cardiac surgery, emergency operation, left main artery disease, Canadian Cardiovascular Society 3-4 class and recent myocardial infarction, states “A Clinical Score to Predict the Need for Intraaortic Balloon Pump in Patients Undergoing Coronary Artery Bypass Grafting.”
 
7. EVIDENCE Rates of local complications from pediatric CAP rising
Rates of local complications from pediatric community-acquired pneumonia (CAP) are “increasing in all age groups,” according to a retrospective, cohort study in August’s Pediatrics. Systemic complications decreased only for children younger than 1 year, states “National Hospitalization Trends for Pediatric Pneumonia and Associated Complications.”

8. CALL TO ACTION Submit methods for preventing SSI to TJC by Sept. 5
The Joint Commission’s (TJC’s) Division of Standards and Survey Methods seeks effective methods for implementing the National Patient Safety Goal (NPSG), “Implement Evidence-based Practices for Preventing Surgical Site Infections.” When the project is complete, accredited hospitals will receive a free NPSG implementation guide that highlights successful implementation methods for this NPSG. Submit your methods.
 
9. CALL TO ACTION Give TJC feedback on Universal Protocol by Sept. 10
The Joint Commission (TJC), Oakbrook Terrace, Ill., wants to know the effect of the changes on patient care and internal processes. Complete a 10-minute survey on the Universal Protocol revisions implemented in January. Deadline Sept. 10.
 
10. CALL TO ACTION Respond to impact of CMS 30-minute rule by Aug. 31
Respond by Aug. 31 to an online survey about the Centers for Medicare & Medicaid Services (CMS), Baltimore, 30-minute rule. The CMS rule that requires medications to be administered within 30 minutes before or after their scheduled times may be causing unintended consequences that affect medication safety. CMS has agreed with a position statement from the American Association of Respiratory Care, Irving, Texas, that states respiratory medications may be given within 60 minutes of their scheduled times. The Institute for Safe Medication Practices, Horsham, Pa., is conducting the survey.
 
11. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
If your hospital, unit or chapter has successfully implemented certification best practices — strategies to encourage, recognize and reward certification — 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.
 
12. 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.
 
13. CLINICAL PRACTICE RESOURCES
Patient Safety
On Aug. 9 the U.S. Food and Drug Administration (FDA), Silver Spring, Md., recommended that physicians remove retrievable inferior vena cava (IVC) filters as soon as protection from pulmonary embolism (PE) isn’t needed. Since 2005, the FDA has received 921 adverse reports for IVC filters, including 328 related to device migration. “The FDA is concerned that these retrievable IVC filters, intended for short-term placement, are not always removed once a patient’s risk for PE subsides,” the announcement states.
 
Evidence
“Certification, Empowerment, and Intent to Leave Current Position and the Profession Among Critical Care Nurses,” in May’s American Journal of Critical Care, found that AACN-certified nurses are less likely to leave their positions and feel more empowered than nurses who are not AACN certified.
“Mechanical Assist Device as a Bridge to Heart Transplantation in Children Less Than 10 Kilograms” calls a ventricular assist device (VAD) in very small children with end-stage heart failure “an effective strategy or bridge to heart transplantation with a reasonable mortality rate.” VAD lasted a median of 89 days and four of the 10 children died. “The high rate of complications suggests to optimize indications and timing of VAD implantation,” concludes the study in July’s Annals of Thoracic Surgery.
 
August’s Journal of Pain and Symptom Management states nurses could use the FICA — Faith or belief, Importance of spirituality, individual’s spiritual Community and interventions to Address spiritual needs — Spiritual History Tool to assess patients’ spirituality needs. “Evaluation of the FICA Tool for Spiritual Assessment” included 76 patients with solid tumors.
 
 
 
14. AACN RESOURCES
Learn at home with E-Learning
Develop your clinical knowledge anywhere, anytime, with the three AACN e-Learning courses that are available for individual purchase. “The Preceptor Challenge” and the award-winning “Promoting Excellence in Palliative & End-of-Life Care” feature simulations of real-life experiences. “Essentials of Nurse Manager Orientation” helps new and experienced managers expand their management competencies. More information and pricing.
 
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