Critical Care Newsline — May 13, 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.

May 13, 2010


1. RESOURCES New certification recognition products honor achievement
2. RESOURCES Second editions of popular AACN nursing books available at NTI
3. NEWS Healthy People initiative increases life expectancy, encourages new directions
4. NEWS National Critical Care Awareness and Recognition Month
5. CALL TO ACTION Help the TJC develop new heart failure standards
6. CALL TO ACTION Participate in Premier Safety Institute injection practices survey
7. NEWS FDA orders recall of Baxter Colleague infusion pumps, requires reimbursement
8. EVIDENCE Coagulopathy doesn’t protect CLD patients from hospital-acquired VTE
9. EVIDENCE Herpes zoster vaccine, well tolerated in seniors without immunocompromise
10. CLINICAL PRACTICE RESOURCES
11. ADDITIONAL AACN RESOURCES Protocols for Practice at reduced rates


1. RESOURCES New certification recognition products honor achievement
Visit the
AACN Online Bookstore to choose from a wide array of new certification recognition products including badge holders, messenger bags, lapel pins and plaques. If you’re attending the National Teaching Institute & Critical Care Exposition (NTI), May 15-20, Washington, D.C., look for these new products and other great educational resources to enhance your professional experience at the NTI Bookstore in the Registration and Resource Center at the Walter E. Washington Convention Center, lower level, Hall AB.

2. RESOURCES Second editions of popular AACN nursing books available at NTI
AACN will make available second editions of three popular nursing books — “AACN Essentials of Critical Care Nursing,” “AACN Essentials of Progressive Care Nursing” and “AACN Essentials of Critical Care Nursing Pocket Handbook” — at the National Teaching Institute & Critical Care Exposition (NTI), Washington, D.C., May 15-20. Visit the NTI Bookstore in the Registration and Resource Center at the Walter E. Washington Convention Center, or the McGraw-Hill Companies, Booth #1518 at the Critical Care Exposition, to buy these books.

3. NEWS Healthy People initiative increases life expectancy, encourages new directions
The Healthy People 2010 initiative increased life expectancy for Americans but failed to meet its “goal of eliminating disparities,” states “
A 2020 Vision for Healthy People,” published in the May 5 New England Journal of Medicine. The Department of Health and Human Services, Washington, D.C., which launched the Healthy People initiative in 1979, prepares for the next decade with Healthy People 2020, aiming to “unify national dialogue about health, motivate action, and encourage new directions in health promotion, providing a public health roadmap and compass for the country,” the article states. Healthy People 2020 starts this fall.

4. NEWS National Critical Care Awareness and Recognition Month
May is National Critical Care Awareness and Recognition Month (NCCARM) supported by AACN, the Society of Critical Care Medicine, American College of Chest Physicians, American Thoracic Society and American Association for Respiratory Care. NCCARM honors dedicated professionals whose compassion and care make a difference in the lives of critically ill patients and their families.
Learn seven ways to celebrate NCCARM.

5. CALL TO ACTION Help the TJC develop new heart failure standards
The Joint Commission (TJC), Oakbrook Terrace, Ill., invites organizations and individuals “involved with the care of heart failure patients” to help develop standards for Phase 2 of its Advanced Certification in Heart Failure Certificate of Distinction program. The program intends to improve outcomes in people with heart failure; Phase 2 expands the program from the hospital to the outpatient setting. Participate by hosting a learning visit, getting involved in pilot tests or focus group calls, or reviewing and commenting on proposed standards.
Complete the required form by May 28.

6. CALL TO ACTION Participate in Premier Safety Institute injection practices survey
Complete a short survey from Premier Safety Institute, Washington, D.C., to help identify practices of clinicians “who prepare or administer parenteral and injectable medications.” Results will be shared with the Centers for Disease Control and Prevention, Atlanta, the U.S. Food and Drug Administration, Silver Spring, Md., and professional groups, to “guide research, outreach and education related to reducing risks to patients.” The deadline to participate is June 18.

7. NEWS FDA orders recall of Baxter Colleague infusion pumps, requires reimbursement
On May 3, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced it ordered Baxter Healthcare Corp., Deerfield, Ill., to
recall and destroy its Colleague Volumetric Infusion Pumps because of “longstanding failure to correct many serious problems” with the device. Baxter must reimburse customers for the device’s value and help them find a replacement. Clinicians and home-care users may continue to use the pumps while FDA works with Baxter to develop “an orderly transition plan,” states FDA’s question and answer page, which adds this is the first time FDA has ordered a device company to reimburse customers.

8. EVIDENCE Coagulopathy doesn’t protect CLD patients from hospital-acquired VTE
Coagulopathy Does Not Protect Against Venous Thromboembolism in Hospitalized Patients With Chronic Liver Disease.” Published in May’s Chest, the retrospective cohort study evaluates venous thromboembolism (VTE) incidence in 190 patients with chronic liver disease (CLD) and concludes, “the notion that ‘auto-anticoagulation’ protects against VTE is unfounded.” It also states, “The primary outcome was the development of VTE during hospital stay” and the use of deep vein thrombosis prophylaxis was “extremely low.”

9. EVIDENCE Herpes zoster vaccine, well tolerated in seniors without immunocompromise
A study in the May 4 Annals of Internal Medicine includes 38,546 immunocompetent adults, 60 years or older and finds that the herpes zoster vaccine protects against the condition. It notes “local inoculation-site side effects” reported by 48 percent of vaccine recipients and 16 percent of placebo recipients in the substudy. “
Safety of Herpes Zoster Vaccine in the Shingles Prevention Study: A Randomized Trial” concludes, “Herpes zoster vaccine is well tolerated in older, immunocompetent adults.”

10. CLINICAL PRACTICE RESOURCES
Patient Safety
Bar-coding with electronic medication-administration systems “substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events,” states a study in the May 6 New England Journal of Medicine. “
Effect of Bar-Code Technology on the Safety of Medication Administration” included 14,041 medication administrations and 3,082 order transcriptions and finds the technology is “an important intervention to improve medication safety.”

Evidence
Effectiveness of Alcohol-Based Hand Rubs for Removal of Clostridium difficile Spores from Hands” states that washing hands with soap and water is “significantly more effective at removing C. difficile spores” than alcohol-based hand rubs (ABHRs). “Residual spores are readily transferred by a handshake after use of ABHR,” adds the abstract published online April 29 by Infection Control & Hospital Epidemiology.

Nurses — 22 percent of the time, on average — “were frequently interrupted while performing safety critical tasks” on the job, states a study in May’s Journal of Nursing Administration. “Nurses are frequently interrupted during safety-critical stages of medication administration, which decreases task efficiency and could lead to adverse events,” concludes “Interruptions During the Delivery of High-Risk Medications.”

11. ADDITIONAL AACN RESOURCES

AACN Protocol for Practice price reductions
Visit the AACN Online Bookstore to buy
AACN Protocols for Practice resources at reduced prices. The list includes “Palliative Care and End-of-Life Issues in Critical Care,” “Non-Invasive Monitoring, 2nd Ed.,” “Creating Healing Environments, 2nd Ed.,” “Care of the Mechanically Ventilated Patient, 2nd Ed.” and “Monitoring Technologies in Critically Ill Neuroscience Patients.”

E-Learning
AACN offers individual nurses access to two of its most popular Web-based courses, “The Preceptor Challenge” and double-award-winning “Promoting 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 LearnCenter. “The Preceptor Challenge,” a three-module course, uses virtual tools to enable nurses to identify best practices. The groundbreaking “Promoting Excellence in Palliative & End-of-Life Care” allows nurses to apply theory-based practice without the risk of harm to patients or families.

Healthy Work Environment
Access
AACN Healthy Work Environment 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 Environment (HWEs). Developed with VitalSmarts, a provider of corporate training and organizational performance products and services in Provo, Utah, the online tools 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.

Access a recording of the live webinar “Assessing the Health of Your Work Environment.” Available on the AACN website, the webinar — a joint venture between AACN and VitalSmarts, Provo, Utah — promises to be of particular interest to users of the AACN Healthy Work Environment Assessment, a Web-based tool that aligns any clinical environment with the six HWE standards. NOTE: Video portion of recording loads slowly.

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