Critical Care Newsline — September 30, 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.

 

September 30, 2010

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1. NEWS TJC reports big improvements in evidence-based care
2. NEWS More than 100 organizations, experts urge preservation of EPA authority
3. CALL TO ACTION AACN grant proposals deadline, tomorrow, Oct. 1
4. CALL TO ACTION CNML Review Course offered in November
5. NEWS AACN members receive discount on ultrasound course
6. EVIDENCE Delirium duration predicts death, ventilation time and ICU stay
7. EVIDENCE QI initiative associated with no improvement in end-of-life care for ICU patients
8. EVIDENCE Constipation causes negative effects in ventilator patients
9. CALL TO ACTION Apply for AACN’s NIWI scholarship by Nov. 1
10. NEWS Latest AACN procedure manual provides current evidence-based support
11. CLINICAL PRACTICE RESOURCES
12. AACN RESOURCES Top-selling mobile pocket cards, 30 percent off

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1. NEWS TJC reports big improvements in evidence-based care
The Joint Commission, Oakbrook Terrace, Ill., reports accredited hospitals in the U.S. “are providing higher-quality, evidence-based care for heart attack, pneumonia, surgical care and children’s asthma care,” according to “Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2010.” The report presents scientific evidence of improvement and how it relates to common medical conditions and procedures. Access quality, safety and patient satisfaction results for specific hospitals.

2. NEWS More than 100 organizations, experts urge preservation of EPA authority
On Sept. 28, more than 100 public health organizations and experts — including the American Nurses Association, Silver Spring, Md. — released a joint letter urging Congress to allow the U.S. Environmental Protection Agency (EPA), Washington, D.C., to “do its job of protecting the public’s health by limiting the pollution that causes global warming.” Preserving EPA’s authority is of paramount concern to the health of “children, older adults, those with serious health conditions and the most economically disadvantaged,” the letter states.

3. CALL TO ACTION AACN grant proposals deadline, tomorrow, Oct.1
Submit proposals for AACN 2011 grants by Oct. 1. New this year is the $50,000 AACN Impact Research Grant, designed to support experienced clinicians and researchers in inquiry and systematic research and generate new knowledge. Other grants range from $1,500 to $10,000 each. Learn more.

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

5. NEWS AACN members receive discount on ultrasound course
The American Institute of Ultrasound in Medicine (AIUM), Laurel, Md., offers AACN members the AIUM nonphysician member registration rate for “Cutting-Edge Applications for Point-of-Care Ultrasound,” which takes place Nov. 6-7 before AIUM’s Ultrasound Practice Forum 2010, Orlando. The course focuses on critical care, anesthesia and emergency medicine. AACN will participate in the forum. Learn more and register.

6. EVIDENCE Delirium duration predicts death, ventilation time and ICU stay
Delirium Duration and Mortality in Lightly Sedated, Mechanically Ventilated Intensive Care Unit Patients” finds that “duration of delirium was the strongest independent predictor of death, ventilation time, and intensive care unit stay.” Critical Care Medicine published the study of 354 patients online Sept. 9.

7. EVIDENCE QI initiative associated with no improvement in end-of-life care for ICU patients
A quality improvement (QI) initiative consisting of clinician education, local champions, academic detailing, clinician feedback of quality data and system supports “was associated with no improvement in quality of dying and no change in ICU length of stay prior to death or time from ICU admission to withdrawal of life-sustaining measures,” according to a study of 12 hospitals published online Sept. 10 by the American Journal of Respiratory and Critical Care Medicine. “Improving ICU end-of-life care will require interventions with more direct contact with patients and family,” concludes “Effect of a Quality-Improvement Intervention on End-of-Life Care in the Intensive Care Unit: A Randomized Trial.”

8. EVIDENCE Constipation causes negative effects in ventilator patients
A study of 609 adults in October’s Critical Care Medicine suggests that constipation is associated with adverse outcomes — higher logistic organ dysfunction scores, higher ICU mortality and more acquired bacterial infections — in long-term ventilated patients. “Constipation in Long-term Ventilated Patients: Associated Factors and Impact on Intensive Care Unit Outcomes” associates a Pao2/Fio2 ratio of less than 150 mm Hg and systolic blood pressure of less than 90 mm Hg during the first five days of mechanical ventilation with defecation delay.

9. 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.

10. NEWS Latest AACN procedure manual provides current evidence-based support
Each procedure in the “AACN Procedure Manual for Critical Care,” 6th edition, contains supporting care recommendations based on the latest AACN Evidence Leveling System, so readers understand the strength of the evidence base. Each procedure in meticulously reviewed to ensure the most authoritative and timely standards of practice have been incorporated.

11. CLINICAL PRACTICE RESOURCES
Patient safety
On Sept. 23, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced it will restrict rosiglitazone (Avandia) to patients with Type 2 diabetes whose diabetes can’t be controlled with other medications. The action responds to data suggesting an elevated risk of cardiovascular events. FDA requires the drug’s manufacturer, GlaxoSmithKline, London, to develop a restricted access program for physicians to document patients’ eligibility and for patients to review a statement on cardiovascular concerns for Avandia. FDA anticipates the program “will limit use of Avandia significantly.”

In Sept. 22’s Joint Commission Online, The Joint Commission, Oakbrook Terrace, Ill., announced — effective immediately — a revision to National Patient Safety Goal 01.03.01 element of performance 1 to make automated identification technology “a first option when verifying patient identification for blood transfusions.” It adds: “Before initiating a blood or blood component transfusion … use a two-person verification process or a one-person verification process accompanied by automated identification technology, such as bar coding.”

Guideline
Access the Agency for Healthcare Research and Quality, Rockville, Md., guideline synthesis “Diagnosis and Treatment of Gastroesophageal Reflux Disease (GERD),” based on an analysis of guidelines from the American Gastroenterological Association Institute, Bethesda, Md., American Society for Gastrointestinal Endoscopy, Oak Brook, Ill., and University of Michigan Health System, Ann Arbor.

12. AACN RESOURCES
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.

Stand Tall
Speak up.” — Kristine Peterson, AACN President 2010-2011

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

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