Critical Care Newsline — November 24, 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.

November 24, 2010

********************************************
1. NEWS One in three Medicare cancer patients dies in hospitals and ICUs
2. NEWS New BSN grads more likely to land jobs
3. NEWS CMS issues final ruling on patient visitation rights
4. NEWS Grant extends work of Surviving Sepsis Campaign
5. NEWS American Academy of Nursing annual report available
6. EVIDENCE NEJM says no mortality differences in stent types for large coronary arteries
7. EVIDENCE CRT reduces mortality in some patients with heart failure, study states
8. EVIDENCE NEJM study reports telemonitoring doesn’t improve HF outcomes
9. CALL TO ACTION Complete tube-feeding practices survey
10. CALL TO ACTION Nominate colleagues for AACN’s Distinguished Research Lectureship
11. CALL TO ACTION Comment on TJC draft for cardiac arrest performance measures
12. CLINICAL PRACTICE RESOURCES
13. AACN RESOURCES Speak boldly with AACN Practice Alerts

********************************************
1. NEWS One in three Medicare cancer patients dies in hospitals and ICUs
Nearly one-third of Medicare patients with advanced cancer die in hospitals and ICUs and only about half receive hospice care according to “Quality of End-of-Life Cancer Care for Medicare Beneficiaries,” which was released Nov. 16 by the Dartmouth Atlas Project, Lebanon, N.H. The report, which found significant regional variation in the amount of inpatient care cancer patients receive, “demonstrates that many hospitals and physicians aggressively treat patients with curative attempts they may not want, at the expense of improving the quality of their last weeks and months.” For additional learning, watch the Frontline episode “Facing Death,” online, which aired on PBS.

2. NEWS New BSN grads more likely to land jobs
BSN-prepared nurses are more likely than other graduates with bachelor’s degrees to receive job offers according to “Employment of New Nurse Graduates from Entry-Level Baccalaureate Programs” a Nov. 10 research brief, from the American Association of Colleges of Nursing, Washington, D.C. A national survey of deans and directors from U.S. nursing schools found that 65 percent of new BSN grads landed job offers at graduation, compared to only 24 percent for other professions. Four to six months later, 89 percent of new BSN graduates had job offers.

3. NEWS CMS issues final ruling on patient visitation rights
Centers for Medicare & Medicaid Services (CMS), Baltimore, published a final ruling in the Nov. 19 Federal Register stating that effective Jan. 18, 2011, Medicare- and Medicaid-participating hospitals must have written policies and procedures on visiting rights for patients and inform them or their representatives of those rights. Hospitals may not restrict or deny visits on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation or disability and must ensure “that all visitors enjoy full and equal visitation privileges consistent with patient preference.”

4. NEWS Grant extends work of Surviving Sepsis Campaign
A $600,000 grant from the Gordon and Betty Moore Foundation, Palo Alto, Calif., will support the continuing work of the Surviving Sepsis Campaign (SSC), including development of revised severe sepsis and septic shock treatment guidelines. AACN is one of the 27 SSC Guideline Sponsors.

5. NEWS American Academy of Nursing annual report available
Access the 2009-10 annual report for the American Academy of Nursing (AAN), Washington, D.C., and learn about AAN’s public policy accomplishments including its responses to passage of the Affordable Care Act and release of “The Future of Nursing: Leading Change, Advancing Health” from the Institute of Medicine, Washington, D.C. AAN’s annual report — distributed at its recent Annual Meeting and Conference in Washington, D.C. — details successes of its programs, including Raise the Voice, Building Academic Geriatric Nursing Capacity, and the Council for the Advancement of Nursing Science.

6. EVIDENCE NEJM says no mortality differences in stent types for large coronary arteries
“Drug-Eluting Versus Bare-Metal Stents in Large Coronary Arteries” finds no significant differences in mortality or myocardial infarction among patients with sirolimus-eluting, everolimus-eluting or bare-metal stents. “With the two drug-eluting stents, similar reductions in rates of target-vessel revascularization were seen,” states the study of 2,314 patients published online Nov. 16 by The New England Journal of Medicine.

7. EVIDENCE CRT reduces mortality in some patients with heart failure, study states
The New England Journal of Medicine reports that adding cardiac-resynchronization therapy (CRT) to an implantable cardioverter-defibrillator reduced rates of death and hospitalization for heart failure in nearly 1,800 patients with New York Heart Association class II or III heart failure, wide QRS complex and left ventricular systolic dysfunction. “This improvement was accompanied by more adverse events,” concludes “Cardiac-Resynchronization Therapy for Mild-to-Moderate Heart Failure," published online Nov. 16.

8. EVIDENCE NEJM study reports telemonitoring doesn’t improve HF outcomes
Telemonitoring of recently hospitalized patients with heart failure (HF) showed no effect on mortality or readmission rates according to a study of 1,653 patients published online Nov. 16 by The New England Journal of Medicine. “The results indicate the importance of a thorough, independent evaluation of disease-management strategies before their adoption,” concludes “Telemonitoring in Patients With Heart Failure.”

9. CALL TO ACTION Complete tube-feeding practices survey
Participate in “A Survey of Tube Feeding Practices by Nurses Working in Adult Intensive Care Units.” Those who completed an earlier mailed survey should not respond again.

10. CALL TO ACTION Nominate colleagues for AACN’s Distinguished Research Lectureship
Nominate colleagues for the 2012 AACN Distinguished Researcher Lectureship by Dec. 1. Eligible nominees are nationally known researchers who have made significant contributions to acute and critical care nursing through research.

11. CALL TO ACTION Comment on TJC draft for cardiac arrest performance measures
Share your thoughts on The Joint Commission’s, Oakbrook Terrace, Ill., Sudden Cardiac Arrest Performance Measures by Dec. 3. A Sudden Cardiac Arrest Initiative panel developed the nine measures that include timeliness of first defibrillation attempt and initiation of therapeutic hypothermia.

12. CLINICAL PRACTICE RESOURCES
Patient safety
On Nov. 19, the U.S. Food and Drug Administration, Silver Spring, Md., announced that Xanodyne Pharmaceuticals, Newport, Ky., has agreed to withdraw propoxyphene (Darvon, Darvocet) from the market because of the drug’s risk for cardiac toxicity even when used in therapeutic doses.

On Nov. 17, The Joint Commission (TJC), Oakbrook Terrace, Ill., issued a Sentinel Event Alert to prevent suicide in emergency departments and on medical/surgical units. The Alert suggests that staff screen patients for suicide risk and implement prevention precautions for those at risk. TJC also urges hospitals to follow accreditation requirement for preventing suicide, ranked by TJC as one of the top five most frequently reported events since 1995.

On Nov. 11, the U.S. Food and Drug Administration, Silver Spring, Md., announced a recall of Spectrum Infusion Pump Model 35700, manufactured by Sigma International in Medina, N.Y., because units may suddenly fail without an alarm sounding. Access Sigma’s Spectrum Pump Voluntary Recall information.

November’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices, Horsham, Pa., discusses how pulling multiple pages through order management scanning systems and fax machines causes drug omissions. Recommendations for avoiding the problem include numbering the pages, removing staples, feeding only one sheet at a time and monitoring for receipt. Subscribe to the free monthly newsletter or read the archives, which ISMP updates each month.

Evidence
The main sources of conflicts in the ICU are end-of-life decisions and communication issues, according to a review article in December’s Current Opinion in Critical Care. Recommendations in “Conflicts and Communication Gaps in the Intensive Care Unit” include developing strategies for conflict prevention and resolution.

Guidelines
November’s Pediatric Emergency Care contains “Updated American College of Critical Care Medicine-Pediatric Advanced Life Support Guidelines for Management of Pediatric and Neonatal Septic Shock: Relevance to the Emergency Care Clinician.”

Download “2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines,” published in November’s Circulation.

13. AACN RESOURCES
Exceptional nurses. Exceptional bestsellers.
Find these and more popular resources at AACN’s Online Bookstore.
Do you take care of kids? www.aacn.org/bestsellers1
Do you need fast facts at your fingertips, pocket cards? www.aacn.org/bestsellers2
Are you a nurse manager or leader? www.aacn.org/bestsellers3
Are you a nurse educator? www.aacn.org/bestsellers4
Getting ready for certification? www.aacn.org/bestsellers5

Speak boldly with AACN Practice Alerts
Access AACN Practice Alerts — concise, action-oriented and evidence-based statements about acute and critical care nursing practices — to help nurses carry their bold voices to the bedside. Each Practice Alert includes the expected practice, scope and impact of the problem, supporting evidence, nursing actions and references. Download the accompanying PowerPoint presentation and Audit Tools to facilitate implementation. Topics include oral care in the critically ill, noninvasive blood pressure monitoring and severe sepsis.

Stand Tall in November’s AACN Bold Voices
“Show me the evidence.” — Kristine Peterson, AACN President 2010-2011

********************************************
If you do not wish to receive e-mail updates from AACN, please reply to unsubscribe@aacn.org.
Do you have a comment, question or story idea for Critical Care Newsline? Send your e-mail to enewsletter@aacn.org.

UPDATE YOUR OWN INFORMATION ONLINE
Did you know you can update your demographic profile, including your e-mail address, online? Simply log in using your membership or customer identification number. Go to:
http://www.aacn.org/DM/CustomerProfile/UpdateCustomerProfile.aspx

 

Your Feedback