Critical Care Newsline — February 4, 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.

Feb. 4, 2010

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1. NEWS AACN to host free webinar, “Assessing the Health of Your Work Environment”
2. NEWS NINR releases free brochure on palliative care
3. EVIDENCE Structured approach, repeated feedback improve ICU room surface cleaning
4. NEWS Joint Commission issues Sentinel Event Alert, “Preventing Maternal Death”
5. EVIDENCE JAMA reports about intensive insulin therapy among sepsis patients
6. EVIDENCE Calf, arm BPs not interchangeable among pediatric patients
7. CLINICAL PRACTICE RESOURCES
8. AACN RESOURCES AACN launches “Response to Haiti Earthquake” Web page

1. NEWS AACN to host free webinar, “Assessing the Health of Your Work Environment”
AACN and VitalSmarts — a provider of corporate training and organizational performance products and services in Provo, Utah — will host a free webinar Tuesday, March 9, 11 a.m. to noon MST. “Assessing the Health of Your Work Environment” promises to be particularly interesting to anyone who uses or plans to use the new AACN Healthy Work Environment Team Assessment, a free Web-based tool that aligns any clinical environment with the six HWE Standards.

2. NEWS NINR releases free brochure on palliative care
The National Institute of Nursing Research, Bethesda, Md., released a free brochure to increase awareness of palliative care for patients and families, titled “Palliative Care: The Relief You Need When You’re Experiencing the Symptoms of Serious Illness.” E-mail info@ninr.nih.gov or call (301) 496-0207 to order up to 25 print copies.

3. EVIDENCE Structured approach, repeated feedback improve ICU room surface cleaning “Improving environmental hygiene in 27 intensive care units to decrease multidrug-resistant bacterial transmission” assesses “the value of a structured intervention program to improve the quality of cleaning.” The study, which appears online Jan. 14 in Critical Care Medicine, reports that “a structured approach that incorporates a simple, highly objective surface targeting method and repeated performance feedback to environmental services personnel” significantly improved ICU room cleaning.

4. NEWS Joint Commission issues Sentinel Event Alert, “Preventing Maternal Death”
“Current trends and evidence suggest that maternal mortality may be increasing,” states a Jan. 26 Sentinel Event Alert from The Joint Commission, Oakbrook Terrace, Ill. “Preventing Maternal Death,” which calls for more attention to this rare but serious issue, proposes suggested actions that include educating physicians and clinicians, identifying triggers to respond to changes in a mother’s vital signs and educating emergency department personnel to be aware that a woman may be pregnant or was recently pregnant.

5. EVIDENCE JAMA reports about intensive insulin therapy among sepsis patients
A randomized trial in Jan. 27’s Journal of the American Medical Association found that compared with conventional insulin therapy, intensive insulin therapy with or without oral fludrocortisone doesn’t reduce mortality among patients who receive hydrocortisone for treatment of sepsis.

6. EVIDENCE Calf, arm BPs not interchangeable among pediatric patients
A study in the Journal of Pediatric Nursing, published online Jan. 25, uses a convenience sample of 221 children to compare upper arm and calf automatic blood pressures (BPs). “Comparison of Arm and Calf Automatic Noninvasive Blood Pressures in Pediatric Intensive Care Patients” reports calf BPs to be higher than arm BPs in most pediatric ICU patients. “Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years,” the abstract concludes.

7. CLINICAL PRACTICE RESOURCES
PATIENT SAFETY
On Jan. 26, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., issued a recall of Huber needles and infusion sets by Nipro Medical Corp., Osaka, Japan, because cutting or dislodging of silicone cores or slivers from needle point insertions occurred in 60 to 72 percent of tests. The FDA also issued precautions for use of Huber needles with ports.

On Jan. 21, Nipro Medical Corp. issued a voluntary recall of GlucoPro insulin syringes because of the potential of needles to detach from syringes.

On Jan. 18, the FDA issued an alert about a potential counterfeit version of the 60 mg over-the-counter weight loss drug Alli. The counterfeit contains sibutramine, a controlled substance, not orlistat, Alli’s active ingredient. Read more, including text and photos of the product differences.

The U.S. Food and Drug Administration, Silver Spring, Md., recently approved Morphine Sulfate Oral Solution, commonly used to relieve moderate-to-severe acute and chronic pain in opioid-tolerant patients. This medicine will be available in 100 milligrams per 5 mL or 20 milligrams per 1 mL, states a Jan. 26 news release. Read more.

8. AACN RESOURCES
AACN launches “Response to Haiti Earthquake” Web page
Visit Response to Haiti Earthquake on the AACN Web site to find information about the massive earthquake that devastated Haiti on Tuesday, Jan. 12. Response to Haiti Earthquake contains links to U.S. government agencies monitoring the earthquake and global relief organizations that provide volunteer and financial support.

CERTIFICATION
Preregister for paper and pencil certification tests to be offered at the 2010 National Teaching Institute & Critical Care Exposition, Washington, D.C., Monday, May 17. Payment must accompany the NTI exam application and be postmarked no later than Wednesday, April 7, 2010.

HEALTHY WORK ENVIRONMENT
Access the new AACN Healthy Work Environment Team 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.

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