Critical Care Newsline — July 29, 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 29, 2010
 
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1. EVIDENCE Updated suctioning guidelines from AARC prohibit saline instillation
2. SAFETY ADVISORY Loose Lovenox label causes needlestick injury, warns ISMP
3. CALL TO ACTION PAD asks for support of congressional resolution
4. EVIDENCE Wake up and breathe not associated with worse long-term outcomes
5. EVIDENCE Constipation causes negative outcomes in ventilated patients, study states
6. NEWS TRENDS certification exam deadline Aug. 13
7. CALL TO ACTION Share certification best practices by Sept. 30, qualify as NTI panelist
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. CALL TO ACTION Comment on CMS proposed visitation ruling by Aug. 27
11. CLINICAL PRACTICE RESOURCES
12. AACN RESOURCES High-quality Web-based courses available
 
1. EVIDENCE Updated suctioning guidelines from AARC prohibit saline instillation
Not instilling normal saline before suctioning ranks among the 10 recommendations from the American Association for Respiratory Care (AARC), Irving, Texas. “AARC Clinical Practice Guidelines: Endotracheal Suctioning of Mechanically Ventilated Patients With Artificial Airways 2010,” in June’s Respiratory Care, targets adults, children and infants and evaluates 114 clinical trials, 62 reviews and six meta-analyses on endotracheal suctioning. It recommends a closed-suction system, suctioning only when secretions occur and limiting suctioning to less than 15 seconds.
 
2. SAFETY ADVISORY Loose Lovenox label causes needlestick injury, warns ISMP
On July 23, the Institute for Safe Medication Practices (ISMP), Horsham, Pa., issued an advisory after a needle on a Lovenox (enoxaparin) prefilled syringe (sanofi-aventis) stuck a nurse. “The manufacturer’s label that was placed around the barrel of the syringe did not fully adhere,” the advisory states. It adds that after the nurse gave the injection and upon removal of the needle from the patient’s skin, “the adhesive caught the nurse’s glove and twisted the syringe, allowing the needle to stick her.”
 
3. CALL TO ACTION PAD asks for support of a congressional resolution
The Peripheral Arterial Disease (PAD) Coalition, Lakewood, Colo., wants nurses to ask their congressional representatives to support H.Res.1438, which encourages government agencies, healthcare organizations, professional societies, health systems and clinicians to take actions that improve PAD diagnosis and treatment.
 
4. EVIDENCE Wake up and breathe not associated with worse long-term outcomes
According to “Long-term Cognitive and Psychological Outcomes in the Awakening and Breathing Controlled Trial” — a study of 180 patients in July 15’s American Journal of Respiratory and Critical Care Medicine — using a wake up and breathe protocol for ICU patients on mechanical ventilation reduces sedation that patients receive and doesn’t cause long-term adverse cognitive, psychological or functional outcomes.
 
5. EVIDENCE Constipation may cause negative outcomes in ventilated patients, study states
Constipation in Long-term Ventilated Patients: Associated Factors and Impact on Intensive Care Unit Outcomes,” a study of 609 patients published online July 15 by Critical Care Medicine, associates this condition with “adverse outcomes in long-term ventilated patients.” Patients with late defecation — passing stools 6 days or later after ICU admission — had higher organ dysfunction scores, more acquired bacterial infections and increased mortality.
 
6. NEWS TRENDS certification exam deadline, 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.
 
7. 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 that 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 5, Chicago. AACN Certification Corporation accepts best-practice submissions and posts them online year-round.
 
8. CALL TO ACTION Apply for Patient Experience Grant Program
Apply by Aug. 31 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
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 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. 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 to require 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.
 
11. CLINICAL PRACTICE RESOURCES
Patient Safety
July’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices, Horsham, Pa., explains how the Centers for Medicare & Medicaid Services (CMS), Baltimore, Md. “30-minute rule,” which requires administering medications 30 minutes before or after their scheduled times, may cause safety issues. Participate in a CMS survey on the topic by Aug. 31.
 
Evidence
Centralized telephone-based management and automated symptom monitoring improved pain and depression in cancer patients according to “Effect of Telecare Management on Pain and Depression in Patients With Cancer,” a randomized clinical trial of 405 patients in July 14’s Journal of the American Medical Association.
 
Guidelines
Access “The International Society of Heart and Lung Transplantation Guidelines for the Care of Heart Transplant Recipients,” published online July 17 by the Journal of Heart and Lung Transplantation. Note: The article takes a moment to download.
 
12. 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. Access 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.
 

Beacon Award for Excellence
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 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 to offer timely feedback and recommendations for every application, and bronze-, silver- and gold-level designations to help units track their progress over time.
 

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