Critical Care Newsline — February 18, 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. 18, 2010

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1. NEWS AACN to host free webinar, “Assessing the Health of Your Work Environment”
2. RESOURCES AACN offers Web-based courses on precepting and palliative care
3. NEWS HRSA expands National Practitioner Data Bank reporting requirements
4. EVIDENCE AHA/ACC issue new guidelines for Torsade de Pointes
5. NEWS FDA launches initiative to reduce unnecessary radiation exposure
6. EVIDENCE Oseltamivir, corticosteroids effective for H1N1, acute lung injury
7. EVIDENCE RIFLE score linked to higher LOS, mortality in pediatric patients
8. NEWS U.S. supply of ventilators adequate to meet H1N1 pandemic needs
9. CLINICAL PRACTICE RESOURCES
10. AACN RESOURCES NTI certification exam application deadline April 7

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 Web-based tool that aligns any clinical environment with the six HWE standards.

2. RESOURCES AACN offers Web-based courses on precepting and palliative care
AACN now offers individual nurses access to two of its most popular Web-based courses, “The Preceptor Challenge” and double-award-winning “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 Learn Center. “The Preceptor Challenge,” a three-module course, uses virtual tools to enable nurses to identify best practices. “Excellence in Palliative & End-of-Life Care” allows nurses to apply theory-based practice without the risk of harm to patients or families.

3. NEWS HRSA expands National Practitioner Data Bank reporting requirements
On Jan. 28, the Health Resources and Services Administration, Washington, issued a final ruling, effective Feb. 27, that requires hospitals, private accrediting organizations and peer-review organizations to report “adverse licensure and other actions against any health care entity,” not just physicians, to the National Practitioner Data Bank.

4. EVIDENCE AHA, ACC issue new guidelines for Torsade de Pointes
On Feb. 8, the American Heart Association, Dallas, and American College of Cardiology, Washington, published “Prevention of Torsade de Pointes in Hospital Settings.” The AACN-endorsed statement calls for greater awareness of drug-induced Torsade de Pointes and having a protocol to treat it. AACN member Barbara J. Drew chaired the committee, which also recommends risk assessment and consistent QT interval monitoring for patients receiving QT-prolonging drugs.

5. NEWS FDA launches initiative to reduce unnecessary radiation exposure
On Feb. 9, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced an initiative to reduce unnecessary radiation exposure from computed tomography, nuclear medicine studies and fluoroscopy. The three-pronged initiative promotes safe use of medical imaging devices, informed clinical decision-making and patient awareness of radiation exposure.

6. EVIDENCE Oseltamivir, corticosteroids effective for H1N1, acute lung injury
Oseltamivir and prolonged use of corticosteroids, which averaged 21 days, improved pulmonary function among ICU patients with acute lung injury and H1N1 influenza, according to a study of 13 patients in January’s Intensive Care Medicine. The findings “provide the rationale for developing a randomized trial.”

7. EVIDENCE RIFLE score linked to higher LOS, mortality in pediatric patients
A prospective study published online Jan. 29 by Critical Care Medicine associates worsening RIFLE (risk, injury, failure, loss and end-stage renal disease) scores with increased length of stay and mortality in pediatric ICU patients. The abstract indicates that “RIFLE criteria serves well to describe acute kidney injury in critically ill pediatric patients.”

8. NEWS U.S. supply of ventilators adequate to meet H1N1 pandemic needs
A national inventory of mechanical ventilators, listed by state, indicates a supply adequate to meet H1N1 influenza pandemic demand if the severity doesn’t change, states information from the U.S. Department of Health and Human Services, Washington.

9. CLINICAL PRACTICE RESOURCES

PATIENT SAFETY
On Feb. 3, Cardiac Science, Bothell, Wash., issued a worldwide voluntary recall of approximately 12,200 automated external defibrillators (AEDs) that may not deliver therapy during resuscitation. The affected AEDs, manufactured or serviced between Oct. 19, 2009 and Jan. 15, 2010, include Powerheart 9300A, 9300E, 9300P and CardioVive 92532, among others. Visit the Cardiac Science Web site to confirm the affected devices.

EVIDENCE
A study in the January/February Journal of Cardiovascular Nursing found no correlation between ankle brachial index and coronary artery disease (CAD) in women. A significant correlation exists between age and CAD and peripheral arterial disease, according to “Ankle Brachial Index as a Prognostic Tool for Women With Coronary Artery Disease.

GUIDELINES
Regional Systems of Care for Out-of-Hospital Cardiac Arrest” from the American Heart Association, Dallas, appears in Feb. 2’s Circulation. The policy statement includes recommended elements of a regional system.

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America” is featured in March’s Clinical Infectious Diseases.

10. AACN RESOURCES

CERTIFICATION
AACN will offer the CCRN, PCCN, CCNS, ACNPC and CNML specialty exams, and the CMC (Cardiac Medicine) and CSC (Cardiac Surgery) subspecialty exams, Monday, May 17 at the
2010 National Teaching Institute & Critical Care Exposition (NTI), Washington, D.C.
Visit the AACN Certification Corporation Web page to access the NTI application and pre-register for the exam. Completed applications with fee payment, sent via postal mail, must be postmarked no later than Wednesday, April 7.

The Kentucky Board of Nursing recognizes AACN Certification Corporation as a national certifying body and approves the ACNPC and CCNS exams for APRN licensure.

RESPONSE TO HAITI EARTHQUAKE
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.

JOURNALS
This month’s Publish Ahead of Print articles are now live on the American Journal of Critical Care Web site. Click the OnlineFirst logo to read about the effect of certification on nurses’ feelings of empowerment and their intent to leave their current position or the profession, and a study to determine the prevalence and predictors of postoperative delirium after colorectal surgery in older patients. Log-in is required to read the articles; abstracts are free access.

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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