Critical Care Newsline — January 28, 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.

Jan. 28, 2010

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1. CALL TO ACTION Beacon Award applications close Jan. 30
2. EVIDENCE Thromboprophylaxis, a common error of omission, study reports
3. NEWS NINR releases free brochure on palliative care
4. EVIDENCE Surviving Sepsis Campaign associated with lower hospital mortality
5. EVIDENCE Formula for point-of-care glucometer reading reduces hypoglycemia
6. EVIDENCE Most ICU alarms not clinically relevant, study says
7. EVIDENCE Family participation improves quality of care, AJCC reports
8. CALL TO ACTION Joint Commission invites effective practice submissions for new guide
9. EVIDENCE Dexmedetomidine reduces cost of long-term sedation better than midazolam
10. EVIDENCE Continuous lateral rotation therapy prevents VAP
11. EVIDENCE Large gaps exist between nutrition recommendations and ICU practice
12. CLINICAL PRACTICE RESOURCES
13. AACN RESOURCES AACN launches “Response to Haiti Earthquake” Web page

1. CALL TO ACTION Beacon Award applications close Jan. 30
Submissions for AACN’s Beacon Award for Critical Care Excellence close Jan. 30 to allow the organization to update process and content criteria to better meet current quality standards. AACN will accept documentation for previously submitted applications on Feb. 1. Visit the AACN Web site to submit an application for this coveted award, which recognizes adult and pediatric critical care and progressive care units that meet evidence-based standards of excellence and patient safety.

2. EVIDENCE Thromboprophylaxis, a common error of omission, study reports
February’s Critical Care Medicine includes an article about thromboprophylaxis in medical-surgical ICU patients. “Because thromboprophylaxis is a common error of omission in hospitalized patients, redoubled efforts are needed to ensure that it is used in practice.”

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

4. EVIDENCE Surviving Sepsis Campaign associated with lower hospital mortality
The Surviving Sepsis Campaign: Results of an international guideline-based performance improvement program targeting severe sepsis” appears in February’s Critical Care Medicine. The abstract associates campaign participation at 165 sites with sustained, continuous quality improvement in sepsis care and notes a reduction in reported hospital mortality rates.

5. EVIDENCE Formula for point-of-care glucometer reading reduces hypoglycemia
A mathematical formula that corrects erroneous point-of-care glucometer values from anemia in ICU patients reduces the prevalence of hypoglycemia during intensive insulin therapy, concludes “Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: Methods of reducing patient risk,” in February’s Critical Care Medicine.

6. EVIDENCE Most ICU alarms not clinically relevant, study says
An observational study in February’s Critical Care Medicine finds most ICU alarms to be not clinically relevant in a university hospital.

7. EVIDENCE Family participation improves quality of care, AJCC reports
The American Journal of Critical Care reports that families who participate with nurses in the care of a relative have improved respect, collaboration, support and overall scores on a family-centered care survey.

8. CALL TO ACTION Joint Commission invites effective practice submissions for new guide
The Joint Commission, Oakbrook Terrace, Ill., seeks examples of effective practices used by hospitals to engage patients and families in safety and quality for possible inclusion in a new national guide, “Advancing Patient and Family Engagement: Developing a Guide to Patient and Family Engagement in Health Care Quality and Safety in the Hospital Setting.” E-mail effective practices to APFE@jointcommission.org. Read submission guidelines for the project —supported by the Agency for Healthcare Research and Quality, Rockville, Md., and led by the American Institutes for Research, Washington, D.C.

9. EVIDENCE Dexmedetomidine reduces cost of long-term sedation better than midazolam
Giving dexmedetomidine for continuous sedation lowers ICU costs compared to midazolam, according to a study of 366 intubated patients from five countries. The $9,679 median reduction resulted primarily from “decreased intensive care unit stay costs and reduced mechanical ventilation costs” states the study, which appears in February’s Critical Care Medicine.

10. EVIDENCE Continuous lateral rotation therapy prevents VAP
A prospective, randomized, clinical study in February’s Critical Care Medicine indicates that continuous lateral rotation therapy reduces ventilator-associated pneumonia. It also shortens ventilator time and length of stay and should be considered in ventilated patients at risk for ventilator-associated pneumonia.

11. EVIDENCE Large gaps exist between nutrition recommendations and ICU practice
“Large gaps” exist between many nutrition recommendations and actual ICU practice reports a prospective, observational study of 2,946 patients on mechanical ventilation in 20 countries in February’s Critical Care Medicine.


12. CLINICAL PRACTICE RESOURCES
Visit Pink Glove Dance to raise awareness for breast cancer
View “Pink Glove Dance” for breast cancer awareness — a YouTube video produced at Providence St. Vincent Medical Center, Portland. Medline, the manufacturer of the video’s Generation Pink gloves, will donate $100,000 to the National Breast Cancer Foundation (NBCF) for education and provide free mammograms for those in need. The company, based in Mundelein, Ill., has donated almost half a million dollars to NBCF over the past four years.

PATIENT SAFETY
Information about a Feb. 18 webinar, “Reducing Medication Safety Risks: Closing the Gap with the ISMP Self Assessment for Automated Dispensing Cabinets,” can be found in January’s Nurse Advise-ERR from the Institute for Safe Medication Practices, Horsham, Pa. It includes information about wearing masks during intrathecal injections and using two unique identifiers to reduce the risk of misfiling clinical reports.

Different assessment tools for intensive care unit delirium: Which score to use?” in February’s Critical Care Medicine reports that the Confusion Assessment Method “showed the best validity of the evaluated scales to identify delirium in ICU patients. The Nu-DESC might be an alternative tool for detection of ICU delirium. The DDS should not be used as a screening tool.”

H1N1
Visit AACN’s H1N1 Influenza Resource Center for up-to-date information about H1N1 etiologies, symptoms and treatments, educational Web tools and journal resources. The site includes links to flu.gov from U.S. Health & Human Services, updates from the Centers for Disease Control, podcasts and more.

GUIDELINES
Access guidelines for rehabilitation after critical illness from the Centre for Clinical Practice, National Institute for Health and Clinical Excellence, London.

13. 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 Tuesday, Jan. 12. “Response to Haiti Earthquake” contains links to U.S. government agencies monitoring the earthquake and global relief organizations organizing volunteer efforts and providing 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. Read more.

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.

EDUCATION
AACN’s Web-based e-learning course “Promoting Excellence in Palliative & End-of-Life Care” recently won a 2009 Gold Brandon Hall Excellence in Learning Award for Best Custom Content, its second industry honor. In July 2009, it won a gold-level “Best of Training Category Horizon Interactive Award,” an industry Oscar, for outstanding achievement in interactive media production. Visit AACN’s Web site to purchase “Promoting Excellence in Palliative & End-of-Life Care” for $50 per user plus the cost of a one-, two- or three-year institutional site license.

AACN offers free online, self-paced course, “Best Practices for Elder Care
Visit the AACN Web site to access “Best Practices for Elder Care,” a free online, self-paced course that addresses complex issues specific to older patients and promotes a healthy work environment. This Web-based resource includes four units of instructional content and interactive case studies and a 17-question self-assessment unit. AACN members earn four free hours of continuing nursing education for completing this program. Nonmembers pay a nominal fee for the four CNE hours.


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