Critical Care Newsline — October 21, 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.

October 21, 2010

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1. NEWS AHA revises CPR and ECC guidelines
2. EVIDENCE Chest-compression-only CPR better for out-of-hospital cardiac arrest
3. NEWS National Healthcare Decisions Day, April 16, 2011
4. NEWS TJC revision allows NPs to order respiratory services
5. CALL TO ACTION Complete survey on LGBT patient and family care by Dec. 31
6. CALL TO ACTION Comment on FAA’s proposed safety rules for air ambulances
7. CALL TO ACTION Join new Nurses’ Health Study
8. CALL TO ACTION Submit healthcare IT success stories to HIMSS by Oct. 22
9. CALL TO ACTION Register for the CNML Review Course
10. CALL TO ACTION Apply for AACN’s NIWI scholarship by Nov. 1
11. CLINICAL PRACTICE RESOURCES
12. AACN RESOURCES Locate TJC and CDC protocol icons with new procedure manual

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1. NEWS AHA revises CPR and ECC guidelines
The American Heart Association (AHA) issued revised guidelines for cardiopulmonary resuscitation (CPR) for lay and professional rescuers that change the recommended sequence of CPR steps from airway-breathing-compressions to compressions-airway-breathing. The change applies to adults, children and infants but excludes newborns. Michael Sayre, guidelines co-author, says the former approach, which instructed people how to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth “was causing significant delays in starting chest compressions essential for keeping oxygen-rich blood circulating through the body.” The AHA also provides revised Emergency Cardiac Care (ECC) guidelines for Advanced Cardiac Life Support and Pediatric Advanced Life Support. Read full-text articles and guidelines.

2. EVIDENCE Chest-compression-only CPR better for out-of-hospital cardiac arrest
“For adults with out-of-hospital cardiac arrest, instructions to bystanders from emergency medical services dispatch should focus on chest-compression-only CPR,” states a study published online Oct. 15 by The Lancet. “Chest-Compression-Only versus Standard Cardiopulmonary Resuscitation (CPR): A Meta-analysis” finds that out-of-hospital cardiac arrest patients who receive chest-compression-only CPR from bystanders have a better chance of surviving than those who receive standard CPR — chest compression and ventilation. 

3. NEWS National Healthcare Decisions Day, April 16, 2011
This week marks six months since the fourth annual National Healthcare Decisions Day (NHDD), which focuses on advance care planning for patients and advance directives for providers. AACN will participate in NHDD, scheduled for Saturday, April 16, 2011. “There shouldn’t be a single adult in the country who hasn’t discussed and documented his/her healthcare wishes,” states NHDD information. Visit National Healthcare Decisions Day to learn more about this initiative, who’s involved with it and sign up your organization.

4. NEWS TJC revision allows NPs to order respiratory services
An Aug. 16 ruling from the Centers for Medicare and Medicaid Services (CMS), Baltimore, allows a qualified, licensed practitioner, responsible for the patient and acting within the scope of their practice, to order respiratory or rehabilitation services. As a result, The Joint Commission (TJC) has aligned their standards by deleting the performance element, “which limited ordering of respiratory services to an M.D. or D.O.,” states Oct. 13’s Joint Commission Online. On its website, the American College of Nurse Practitioners, Arlington, Va., notes that licensed practitioners include nurse practitioners (NPs) and physician assistants.

5. CALL TO ACTION Complete survey on LGBT patient and family care by Dec. 31
The Joint Commission (TJC), Oakbrook Terrace, Ill., invites organizations to complete the Human Rights Campaign Healthcare Equality Index 2010 Survey — a self-assessment tool to measure compliance with best practices for lesbian, gay, bisexual and transgender (LGBT) patients and families. The Human Rights Campaign, Washington, D.C., recognizes top-performing facilities and awards a logo to use in advertising and marketing. If you are authorized to represent your employer, e-mail HEI@hrc.org to obtain your facility’s unique username and password for the survey. If you aren’t authorized, e-mail the name, position, e-mail and mailing address of the appropriate contact, typically human resources, diversity, staffing, communications or marketing professionals.

6. CALL TO ACTION Comment on FAA’s proposed safety rules for air ambulances
Comment on the new safety rules for air ambulances, which the Federal Aviation Administration (FAA), Washington, D.C., proposes by Jan. 10, 2011. The new rules would “require stricter flight rules and procedures, improved communications and training, and additional on-board safety equipment,” the FAA states. Send comments online.

7. CALL TO ACTION Join new Nurses’ Health Study
Join Nurses’ Health Study (NHS) III — a new study designed to learn about how women’s lifestyles, including exercise, diet and birth control, during their 20s, 30s and 40s — can influence health throughout their lives. NHS III builds on the two previous Nurses’ Health Studies, showing that lifestyle factors “can powerfully promote better health,” NHS states.

8. CALL TO ACTION Submit healthcare IT success stories to HIMSS by Oct. 22
Submit success stories that discuss the use of information technology (IT) to improve patient safety for possible inclusion in Stories of Success, sponsored by Healthcare Information and Management Systems Society (HIMSS), Chicago; American Society for Quality, Milwaukee; the National Committee for Quality Assurance, Washington, D.C., and the National Patient Safety Foundation, Boston. The program illustrates how IT helps to fulfill The Joint Commission’s, Oakbrook Terrace, Ill., national patient safety recommendations put forth by the National Priorities Partnership and National Patient Safety Goals. Read past case studies. Submission deadline Oct. 22.

9. CALL TO ACTION Register for the CNML Review Course
Join fellow nurse managers and leaders for the CNML Review Course, Monday and Tuesday, Nov. 1-2, at the Hilton Chicago O’Hare Airport. Presented by AACN and the American Organization of Nurse Executives (AONE), Chicago, the 11-hour course includes case studies and dialogue. AACN and AONE members receive discounted tuition. Learn more or contact cnmlreview@aacn.org.

10. CALL TO ACTION Apply for AACN’s NIWI scholarship by Nov. 1
For the second year, AACN offers scholarships for the Nurse in Washington Internship (NIWI) program — sponsored by the Nursing Organizations Alliance — Sunday, March 13, to Tuesday, March 15, 2011, in Washington, D.C. The three-day internship teaches healthcare professionals how to advance healthcare agendas on local, state and national levels through legislative processes. Applicants must be AACN members and accepted by the NIWI program. The deadline is Nov. 1. Learn more at www.nursing-alliance.org and www.aacn.org/niwi.

11. CLINICAL PRACTICE RESOURCES
Patient safety
October’s “Nurse Advise-ERR” published by the Institute for Safe Medication Practices (ISMP), Horsham, Pa., states mix-ups between DTaP (diphtheria and tetanus toxoids, acellular pertussis) vaccine, used for ages 6 weeks through 6 months, and Tdap (tetanus toxoid, reduced diphtheria toxoid, acellular pertussis) vaccine, used as booster shots for older children, adolescents and adults, now affect hundreds of patients. Recommendations to avoid mix-ups include separate storage for the two types and asking pharmacy to place additional warnings. Subscribe to the free monthly newsletter or read the archives, which ISMP updates each month.

Has the Time Come to Phase Out Codeine?” an editorial published online Oct. 4 by CMAJ, the journal of the Canadian Medical Association, states codeine has “poor analgesic properties” and raises concerns about genetic variations that can lead to adverse effects. The authors recommend phasing out codeine in favor of morphine — codeine’s active metabolite — especially in infants and young children, who are at the highest risk.

12. AACN RESOURCES
Locate TJC and CDC protocol icons with new procedure manual
Access updated advanced practice procedures and locate protocol icons for The Joint Commission (TJC), Oakbrook Terrace, Ill., and the Centers for Disease Control and Prevention (CDC), Atlanta, in the 6th edition of the “AACN Procedure Manual for Critical Care.” Written by critical care nursing experts, this new compendium documents references and evidence levels for practice procedures. AACN members receive a discount for this critical care go-to guide available on the AACN Online Bookstore.

Top-selling mobile pocket cards, 30 percent off
Buy six top-selling pocket cards for your iPhone or iPod Touch at a 30 percent discount at AACN’s Mobile Resource Center. These mobile pocket cards provide a ready reference at the point of care and include Cardiac Medications Pocket Reference, Cardiovascular Assessment Pocket Reference, Hemodynamic Management Pocket Reference, Laboratory Values Pocket Reference, Patient/Family Guide Conference Pocket Reference and Sepsis Management Pocket Reference. Offer ends Oct. 31.

Learn at home with E-Learning
Develop your clinical knowledge, anytime, anywhere, with the three AACN E-Learning courses, available for individual purchase. “The Preceptor Challenge” and the award-winning “Promoting Excellence in Palliative & End-of-Life Care” feature simulations of real-life experiences. “Essentials of Nurse Manager Orientation” helps new and experienced managers expand their management competencies. More information and pricing.

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