Critical Care Newsline — April 28, 2011

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.

April 28, 2011

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1. NTI Register on-site for the Procedural Anatomy Cadaver Lab
2. NTI ‘Silent Treatment,’ HWE-track session at NTI
3. NEWS Silent Treatment webcasts offer practical solutions to improve patient safety
4. NEWS New temperature recommendations for critical care
5. EVIDENCE Study identifies CLABSI risk factors in children with PICCs
6. EVIDENCE CAUTI increases mortality in critically ill patients
7. RESOURCE AACN’s Adult CCRN/CCRN-E online review course
8. EVIDENCE CVC-related DVT lengthens ventilator time in critically ill children
9. EVIDENCE Expanded barrier precautions don’t reduce bacteria transmission, NEJM states
10. RESOURCE SCCM plans webcast on ECMO
11. CALL TO ACTION Apply for HRSA nursing student scholarships by June 1
12. CLINICAL PRACTICE RESOURCES
13. AACN RESOURCES Add NTI Mobile
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1. NTI Register on-site for the Procedural Anatomy Cadaver Lab
Want to see real-world critical care anatomy procedures performed on cadavers? Come to one of two Procedural Anatomy Labs on Sunday, May 1, from 9 a.m.-noon, and 1:30-4:30 p.m. Space is limited for these popular half-day preconferences that explore the risks and complications of procedures performed during suboptimal conditions — scenarios such as rapid response for patients experiencing sepsis or therapeutic hypothermia for cardiac arrest. Sponsored by Vidacare Corp., San Antonio, and the Medical Education & Research Institute, Memphis, Tenn., these important hands-on sessions help you make informed patient-care decisions. View pictures from last year.

2. NTI ‘Silent Treatment,’ HWE-track session at NTI
Want to learn more about “Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives”? Take in this Healthy Work Environment (HWE)-track session by David Maxfield at the National Teaching Institute & Critical Care Exposition (NTI), which takes place in Chicago, Tuesday, May 3, 12:30-1:45 p.m. Maxfield, Silent Treatment lead researcher and vice president of research at VitalSmarts, Provo, Utah, partnered with AACN and the Association of periOperative Registered Nurses, Denver, to look at the dangers of communication breakdowns at the point of care. Do you use a smartphone? Look for this session and add it to NTI Mobile.

3. NEWS Silent Treatment webcasts offer practical solutions to improve patient safety
AACN has partnered with Association of periOperative Registered Nurses, Denver, and VitalSmarts, Provo, Utah, to present “The Silent Treatment Learning Series” — a three-part series of interactive video webcasts to help your healthcare team communicate openly and assertively. Each 75-minute webcast takes place May 17, July 20 and Sept. 13.

4. NEWS New temperature recommendations for critical care
Targeted Temperature Management in Critical Care: A Report and Recommendations From Five Professional Societies” strongly recommends 32°C–34°C as the target for out-of-hospital adult cardiac arrest victims found in ventricular fibrillation or pulseless ventricular tachycardia who remain unconscious after their pulse returns. The report in May’s Critical Care Medicine also recommends replacing the term “therapeutic hypothermia” with “targeted temperature management.”

5. EVIDENCE Study identifies CLABSI risk factors in children with PICCs
Central Line-Associated Bloodstream Infection (CLABSI) in Hospitalized Children With Peripherally Inserted Central Venous Catheters (PICCs)” lists predictors of infection as prolonged catheter dwell time, a pediatric ICU stay during hospitalization and administration of parenteral nutrition as the reason for the PICC. “A careful assessment of these risk factors may be important for future success in preventing CLABSIs,” concludes the study in May 1’s Clinical Infectious Diseases.

6. EVIDENCE CAUTI increases mortality in critically ill patients
Catheter-associated urinary tract infection (CAUTI) significantly increases mortality and length of stay in critically ill patients according to May’s Critical Care Medicine. The findings show the “importance of evaluating risks and benefits of commonly used treatments such as antibiotics” to manage CAUTI, states “Relationship of Catheter-Associated Urinary Tract Infection to Mortality and Length of Stay in Critically Ill Patients: A Systematic Review and Meta-Analysis of Observational Studies.”

7. RESOURCE AACN’s Adult CCRN/CCRN-E online review course
Experience the easy access and convenience of preparing for your AACN Adult CCRN/CCRN-E certification exam online. With AACN’s latest addition to the Certification Reviews Online selections, you can study anytime and anywhere — and as often as you like — using an Internet connection. The 14.5-contact-hour course offers a comprehensive review, in which a distinguished national panel of prominent experts from the critical care nursing community prepares you for the certification exam given by AACN Certification Corporation.

8. EVIDENCE CVC-related DVT lengthens ventilator time in critically ill children
Mortality-Adjusted Duration of Mechanical Ventilation in Critically Ill Children With Symptomatic Central Venous Line (CVC)-related Deep Venous Thrombosis (DVT)” states that CVC-related DVT decreased “ventilator-free days” — unassisted breathing for 28 days after CVC insertion. The “causal relationship” that DVT leads to delayed weaning from mechanical ventilation and discharge from the ICU “needs to be proven prospectively,” states the prospective matched cohort study in May’s Critical Care Medicine.

9. EVIDENCE Expanded barrier precautions don’t reduce bacteria transmission, NEJM states April 14’s New England Journal of Medicine (NEJM) reports that expanded use of barrier precautions over six months failed to reduce transmission of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus in adult ICUs. However, “the use of barrier precautions by providers was less than what was required,” concludes “Intervention to Reduce Transmission of Resistant Bacteria in Intensive Care.”

10. RESOURCE SCCM plans webcast on ECMO
Next in the Society of Critical Care Medicine (SCCM), Mount Prospect, Ill., webcast series is “Lessons You Need to Know When Providing ECMO" (extracorporeal membrane oxygenation) on Thursday, May 19, from 2-3:30 p.m., Eastern. Learn more and register.

11. CALL TO ACTION Apply for HRSA nursing student scholarships by June 1
Apply for the Health Resources and Services Administration’s (HRSA), Rockville, Md., Nursing Scholarship Program for RN students in accredited schools of nursing. Deadline June 1.

12. CLINICAL PRACTICE RESOURCES
Patient safety
On April 15, the U.S. Food and Drug Administration, Rockville, Md., recommended not giving lansoprazole delayed-release orally disintegrating tablets, manufactured by Teva Pharmaceuticals, North Wales, Pa., through an oral syringe or feeding tube because of potential clogging.

A patient safety program designed to improve teamwork and culture significantly improved overall safety climate scores according to May’s Critical Care Medicine. “Research linking improved climate scores and clinical outcomes is a critical next step,” concludes “Assessing and Improving Safety Climate in a Large Cohort of Intensive Care Units.”

April’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices (ISMP), Horsham, Pa., states that pharmacist supervision is critical for proper preparation of CLINMIX E multi-chamber bags. Other articles discuss risks of adding the drug to a hanging IV bag and standard NICU drug infusion concentrations. Subscribe to the free monthly newsletter or read the archives, which ISMP updates each month.

13. AACN RESOURCES
Add NTI Mobile
Add NTI Mobile to your smartphone at www.aacn.org/ntimobile to access class descriptions, submit evaluations so you can receive continuing education credit, search for exhibitors and much more.

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