Critical Care Newsline — July 1, 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.

July 1, 2010

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1. NEWS AACN’s 2011 fiscal year welcomes Kristine Peterson as president
2. NEWS Nurse Advise-ERR discusses alphanumeric symbols and misleading drug promotion
3. NEWS ANA elects Karen Daley as new president
4. CALL TO ACTION Comment on CMS proposed visitation ruling
5. EVIDENCE ICU delirium duration predicts long-term cognitive impairment
6. EVIDENCE Small difference in continuous vs. bolus dosing of furosemide in HF patients
7. CALL TO ACTION Submit Circle of Excellence award nominations by Aug. 1
8. NEWS AACN’s new Beacon Award for Excellence applications open Nov. 1
9. CALL TO ACTION Participate in a survey about the PICU environment
10. CLINICAL PRACTICE RESOURCES
11. AACN RESOURCES CCN OnlineFirst articles now live

1. NEWS AACN’s 2011 fiscal year welcomes Kristine Peterson as president
July 1, 2010 marks the start of AACN’s 2011 fiscal year and the tenure of new board members. Kristine Peterson begins a one-year term as AACN president with “Stand Tall,” a theme that “recognizes the unique and indispensable role nurses play.” Mary Stahl rejoins the AACN board of directors for a one-year term as president-elect. Sheryl Leary, Pamela Popplewell and Maureen Seckel join the board for three-year director terms. AACN applauds and thanks outgoing board members, including Beth Hammer, who becomes immediate past president, for their significant contributions and the nominating committee for the slate of candidates. Thank you to all who voted.

2. NEWS Nurse Advise-ERR discusses alphanumeric symbols and misleading drug promotion
June’s  Nurse Advise-ERR, published by the Institute for Safe Medication Practices (ISMP), Horsham, Pa., discusses the problem of alphanumeric symbols — letters and numerals — in written and computer-generated communication and gives seven ways to prevent confusion. These include using block printing and lightly lined forms. Other articles discuss the dangers of reporting misleading drug promotion and confusing cold storage solutions with IV bags. Subscribe to the free monthly newsletter or read the archives, which ISMP updates each month.

3. NEWS ANA elects Karen Daley as new president
Delegates to the American Nurses Association (ANA) biennial meeting, June 16-19 in Washington, D.C., elected Karen Daley to a two-year term as ANA president. Daley, an advocate for needlestick safety in the workplace, says, “We have exciting and challenging work ahead. As an association and profession, we must draw on the strength of our values — for the challenges that we face may have changed, but the things that we believe in do not.”

4. CALL TO ACTION Comment on CMS proposed visitation ruling
The Centers for Medicare & Medicaid Services (CMS), Baltimore, requests comments by Aug. 27 on a proposed ruling requiring hospitals that participate in Medicare and Medicaid programs to have written policies and procedures on patients’ visitation rights. The president’s directive instructed 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 also suggests rulemaking may need to allow participating hospitals to “restrict visitation in medically appropriate circumstances.”
Read more in the April 29 Critical Care Newsline.

5. EVIDENCE ICU delirium duration predicts long-term cognitive impairment
Duration of delirium for ICU patients on mechanical ventilation predicts cognitive function three months and one year after discharge according to “Delirium as a Predictor of Long-term Cognitive Impairment in Survivors of Critical Illness,” a prospective cohort study in July’s Critical Care Medicine.

6. EVIDENCE Small difference in continuous vs. bolus furosemide dosing in HF patients
Continuous Versus Bolus Dosing of Furosemide for Patients Hospitalized for Heart Failure” (HF) found no significant difference in creatinine or length-of-stay from admission to the third day of hospitalization or discharge between the two treatment groups. “Larger multicenter blinded studies are needed,” states the randomized, open-label study of 41 patients published June 15 by the American Journal of Cardiology.

7. CALL TO ACTION Submit Circle of Excellence award nominations by Aug. 1
AACN accepts nominations of individuals and chapters for the 2011 Circle of Excellence awards through Aug. 1. Up to 25 individuals receive the awards, conferred to nurses who exemplify excellence in the care of acutely and critically ill patients and families, and $1,000 honorariums. Chapters may be nominated in several categories. Learn about the awards, review the criteria and complete a nomination form.

8. NEWS AACN’s new Beacon Award for Excellence applications open Nov. 1
Starting Nov. 1, any hospital unit that cares for high acuity or critically ill patients can apply for an AACN Beacon Award for Excellence. The revised program aligns more closely with award programs such as the Malcolm Baldrige Award for Quality and Magnet Recognition Program, making it easier for hospitals applying for multiple recognition programs to meet requirements for nursing-sensitive patient benchmark data. In addition, the new Beacon program includes a streamlined review process that offers timely feedback and recommendations for every application, and bronze-, silver- and gold-level designations to help units track their progress over time.

9. CALL TO ACTION Participate in a survey about the PICU environment
As part of a graduate study, researchers at Salem State College, Mass., investigate how treating critically ill patients in an environment such as the pediatric intensive care unit impacts nurses. Participate in the survey by Friday, July 16.

10. CLINICAL PRACTICE RESOURCES
Patient Safety
On June 16, the American Society of Health-System Pharmacists, Bethesda, Md., and the Institute for Safe Medication Practices, Horsham, Pa., issued a National Alert Network message to warn healthcare practitioners about dangerous medical errors that could occur because of a shortage of epinephrine pre-filled syringes. The alert gives suggestions to prevent errors such as conserving epinephrine emergency syringes for code boxes.

Access two new guides from the Agency for Healthcare Research and Quality, Rockville, Md.: “Hospital Evacuation Decision Guide” and “Hospital Assessment and Recovery Guide,” to help administrators determine when to evacuate a hospital during an emergency and when it’s safe to return.

Evidence
Accountability Measures – Using Measurement to Promote Quality Improvement,” published online June 23 by New England Journal of Medicine, suggests the four criteria for vetting a quality measure as: 1) strong evidence for the process to improve outcomes; 2) ability to accurately determine whether the care has been delivered; 3) a process to close the desired outcome; and 4) implementation with minimal or no unintended adverse consequences. “The Joint Commission is incorporating this framework into its programs,” the article states.

Resources
Access “A Guide to Writing and Designing Easy-to-Use Health Web Sites” from the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion, Bethesda, Md. The research-based guide explains how to create websites and content for those with limited literacy and online skills.

Download the free application iScrub Lite 1.5.1 for the iPhone and iPod touch to monitor hand hygiene compliance more efficiently and accurately.

Toward an Integrated Research Agenda for Critical Illness in Aging,” published online June 17 by American Journal of Respiratory and Critical Care Medicine, reviews knowledge gaps, research barriers and opportunities to promote “an integrated research agenda” for the aging population. Patients 65 years or older comprise about half of all ICU admissions in the U.S., but “existing evidence-based interventions are frequently underutilized and their efficacy untested in older subjects” despite research that suggests elderly survivors of ICU “suffer significant long-term sequelae, including accelerated age-related functional decline,” the review states.

11. AACN RESOURCES
New CCN OnlineFirst articles now live
Click the OnlineFirst logo on the Critical Care Nurse website to read about the role of prasugrel in the management of acute coronary syndromes and neuromonitoring in patients with traumatic brain injury. Member login is required to read articles.

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 and 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.

Healthy Work Environment
Access AACN’s Healthy Work Environment tools.

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