Critical Care Newsline — July 15, 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 15, 2010

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1. NEWS AAN calls advance care planning an ‘urgent public health concern’
2. NEWS ANA backs Registered Nurse Safe Staffing Act of 2010
3. CORRECTION AACN and AACN Cert. Corp. were CNS task force stakeholders
4. NEWS Certification exam deadline for TRENDS is Aug. 13
5. CALL TO ACTION Participate in a survey about the PICU environment by July 16
6. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
7. EVIDENCE Weekend ICU admission increases mortality risk, study states
8. CALL TO ACTION Apply for Patient Experience Grant Program by Aug. 1
9. CALL TO ACTION Submit Circle of Excellence award nominations by Aug. 1
10. EVIDENCE SfvO2 isn’t a reliable substitute for ScvO2, study states
11. CALL TO ACTION Comment on CMS proposed visitation ruling by Aug. 27
12. EVIDENCE Heparin infusion after cardiac surgery in infants fails to prevent thrombosis
13. NEWS AACN’s new Beacon Award for Excellence applications open Nov. 1
14. CLINICAL PRACTICE RESOURCES
15. AACN RESOURCES High-quality Web-based courses available


1. NEWS AAN calls advance care planning an ‘urgent public health concern’
On July 6, the American Academy of Nursing (AAN), Washington, D.C., endorsed end-of-life care conversations with patients in its policy brief, “Advance Care Planning as an Urgent Public Health Concern.” AAN says it is “disturbed and disappointed by attempts” to bring healthcare to a “standstill by calling compassionate care ‘death panels,’ and thereby frighten older adults and their families.” AAN President Catherine L. Gilliss says, “Through our End of Life Task Force, the Academy sought to debunk the misconceptions hindering the practice of advance care planning.” Test your palliative and end-of-life skill levels and bridge knowledge gaps with AACN’s self-assessment tool.

2. NEWS ANA backs Registered Nurse Safe Staffing Act of 2010
On July 7, the American Nurses Association (ANA), Silver Spring, Md., applauded the introduction of the Registered Nurse Safe Staffing Act of 2010 (S. 3491/H.R. 5527), saying the legislation empowers RNs to drive staffing decisions in hospitals that improve quality of care. The bill would require hospitals to establish committees to create unit-specific nurse staffing plans based on factors such as patient severity, RN skills, available support staff and technology resources. It also would restrict floating, require a complaint process and provide whistle-blowing protection.

3. CORRECTION AACN and AACN Cert. Corp. were CNS task force stakeholders
AACN’s July 8 Critical Care Newsline incorrectly reported that a “national task force, facilitated by AACN Certification Corporation (AACN Cert. Corp.), American Nurses Association, Silver Spring, Md., and American Board of Nursing Specialties, Aurora, Ohio, released new ‘Clinical Nurse Specialist (CNS) Core Competencies.’” AACN Certification Corporation and AACN were stakeholders on the national CNS competency task force, not facilitators. Carol Hartigan, AACN certification programs strategist, represented the certification corporation. AACN Past President Ann Wojner Alexandrov represented the association. We apologize for any confusion caused by the announcement. Review the Executive Summary. Also read page 41 of “Consensus Model for APRN Regulation” for information about the national consensus-building process.

4. NEWS Certification exam deadline for TRENDS is Aug. 13
AACN will offer all certification exams at the TRENDS conference in Philadelphia on the morning of Friday, Oct. 1. Preregister to take an exam by Friday, Aug. 13.

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

6. CALL TO ACTION Share certification best practices by Sept. 30; qualify as NTI panelist
If your facility or chapter has successfully implemented certification best practices — strategies to encourage, recognize and reward certification — in your hospital or unit, 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 11, Chicago. AACN Certification Corporation accepts best-practice submissions, which it posts online year-round.

7. EVIDENCE Weekend ICU admission increases mortality risk, study states
Patients admitted to the ICU during weekends “appear to be at increased risk of death,” states “Association Between Time of Admission to the ICU and Mortality: A Systematic Review and Metaanalysis” in July’s CHEST. The analysis attributes the increase to a “lower level of staffing and intensity of care” on weekends. Nighttime admission wasn’t associated with increased mortality.

8. CALL TO ACTION Apply for Patient Experience Grant Program by Aug. 1
Apply by Aug. 1 to receive one of four $1,000 Patient Experience Grants from The Beryl Institute, Bedford, Texas. The new grant program supports research to improve the patient-care experience.

9. CALL TO ACTION Submit Circle of Excellence award nominations by Aug. 1
AACN will accept nominations of individuals and chapters for the 2011 Circle of Excellence Awards through Aug. 1. Up to 25 individuals receive the awards — conferred on 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.

10. EVIDENCE SfvO2 isn’t a reliable substitute for ScvO2, study states
July’s CHEST includes “Femoral-Based Central Venous Oxygen Saturation (SfvO2) Is Not a Reliable Substitute for Subclavian/Internal Jugular-Based Central Venous Oxygen Saturation (ScvO2) in Patients Who Are Critically Ill.” It reports that more than half of SfvO2 and ScvO2 values diverged by more than 5 percent and concludes SfvO2 “should not routinely be used in protocols to help guide resuscitation.”

11. CALL TO ACTION Comment on CMS proposed visitation ruling by Aug. 27
The Centers for Medicare & Medicaid Services, 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 rulemaking consider allowing participating hospitals to “restrict visitation in medically appropriate circumstances.” Read more in the April 29 Critical Care Newsline.

12. EVIDENCE Heparin infusion after cardiac surgery in infants fails to prevent thrombosis
July’s Pediatric Critical Care Medicine includes “A Continuous Heparin Infusion Does Not Prevent Catheter-Related Thrombosis in Infants After Cardiac Surgery,” a randomized, placebo-controlled, double-blinded trial of 90 infants. The study — discontinued early after a “futility analysis” — calls 10 units/kg/hr heparin infusion safe but warns of an “increase in partial thromboplastin time values, which, unexpectedly, was more pronounced in neonates.”

13. 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. 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.

14. CLINICAL PRACTICE RESOURCES
Evidence
According to “Decrease in Staphylococcus aureus Colonization and Hospital-Acquired Infection in a Medical Intensive Care Unit After Institution of an Active Surveillance and Decolonization Program,” published online July 1 by Infection Control & Hospital Epidemiology, surveillance combined with intranasal mupirocin for nasal carriers of S. aureus reduced S. aureus hospital-acquired infection from 3.52 to 1.29 cases per 1,000 patient days.

Resource
The iPhone and iPod touch application iScrub Lite 1.5 — developed at the University of Iowa in collaboration with the U.S. Centers for Disease Control and Prevention, Atlanta, and coinciding with the World Health Organization’s (WHO’s) “Save Lives: Clean Your Hands” annual initiative — makes monitoring hand-hygiene compliance more efficient and accurate. It enables users to record observations using “In Room-Out of Room” or the WHO’s “Five Moments of Hand Hygiene” compliance models, export observational data to a spreadsheet and add custom locations, job roles and observation notes to their recorded data.

15. AACN RESOURCES
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 & 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. Find more information and pricing.

‘Stand Tall’ Resources
AACN’s annual theme is a rallying cry that gathers the organization’s mission, vision, core values and strategic direction in a meaningful way. Kristine Peterson, who became AACN president July 1, at the start of AACN’s fiscal year 2011, calls on nurses to “Stand Tall.” This year, AACN introduces Stan Tall, its first theme mascot. Download Stan and learn more. Become Stan’s friend on Facebook.

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

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