Critical Care Newsline — December 1, 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.

Dec. 1, 2011

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1. ALERT Family Visitation in the ICU
2. ALERT Prevention of Aspiration
3. ALERT Catheter-Associated Urinary Tract Infections
4. ALERT Delirium Assessment and Management
5. GUIDELINES CDC revises guidelines to prevent intravascular catheter-related infections
6. CALL TO ACTION Apply for HHS-CCSC HAI award
7. CALL TO ACTION Participate in survey on providing care when guidelines are lacking
8. CALL TO ACTION Submit nominations for AACN President’s Awards for Chapters
9. EVIDENCE Pneumonia is most common infection after heart surgery
10. EVIDENCE Burden of early-onset neonatal sepsis remains high
11. EVIDENCE Simulation study day can improve ICU teamwork
12. EVIDENCE New report urges greater integration of palliative care into ICU
13. CALL TO ACTION Apply for funding to assess point-of-care ultrasound competency
14. CALL TO ACTION Comment on FDA’s proposed opioid training program
15. MEMBER BENEFIT Free enrollment in ChangeAnything.com for one year
16. CLINICAL PRACTICE RESOURCES
17. AACN RESOURCES Buy your holiday gifts online
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1. ALERT Family Visitation in the ICU
The unrestricted presence and participation of patients’ family members and friends has wide-reaching benefits for patients, both medically and emotionally. This AACN Practice Alert outlines administrative and practical considerations for implementing less-restrictive access to the bedside for these “partners in care.”

2. ALERT Prevention of Aspiration
Critically ill patients, especially those who are tube-fed, may experience micro-aspirations, which greatly increase the risk for pneumonia and other complications. This AACN Practice Alert offers a checklist for aspiration prevention, including head-of-bed elevation, assessment of sedation levels and feeding-tube placement.

3. ALERT Catheter-Associated Urinary Tract Infections
Catheter-associated urinary tract infections account for nearly 40 percent of hospital-acquired infections in acute care hospitals today, leading to increased hospital costs and higher patient morbidity and mortality rates. This AACN Practice Alert stresses pre- and post-catheterization assessments to gauge proper catheter use and early indications of infection.

4. ALERT Delirium Assessment and Management
Studies show that delirium in the ICU often goes undetected and therefore untreated, leading to delirium-associated costs of between $4 billion and $16 billion annually in the United States. While no FDA-approved drugs are available to treat delirium, this AACN Practice Alert explains that implementing early assessment, prevention and detection protocols such as the described ABCDE bundle reduces risk factors.

5. GUIDELINES CDC revises guidelines to prevent intravascular catheter-related infections
The Centers for Disease Control and Prevention (CDC), Atlanta, has issued “Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011,” replacing the 2002 guidelines. Access a summary.

6. CALL TO ACTION Apply for HHS-CCSC HAI award
Apply by Monday, Dec. 19, for national awards recognizing sustained improvements in reducing or eliminating healthcare-associated infections (HAIs) in critical care. Now in its second year, this awards program is sponsored by AACN and its partnering organizations in the Critical Care Societies Collaborative (CCSC), U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health and Office of Healthcare Quality (HHS), emphasizing success related to reducing or eliminating central line-associated bloodstream infections and ventilator-associated pneumonia. Access eligibility, selection criteria and application requirements.

7. CALL TO ACTION Participate in survey on providing care when guidelines are lacking
You are invited to participate in a series of three confidential online questionnaires about the opinions of critical care nurses regarding care provided when standard practice guidelines are lacking, to meet patient-specific care needs. Doctoral student Jodie Gary from the University of Texas at Tyler College of Nursing requests your participation as an expert in your field to find areas of agreement and gaps in knowledge. Read inclusion criteria and participate.

8. CALL TO ACTION Submit nominations for AACN President’s Awards for Chapters
Nominate chapters for the 2012 AACN President’s Awards for Chapters, which recognize the chapters that best exemplify the association’s annual theme. Learn more and nominate by Wednesday, Feb. 15, 2012.

9. EVIDENCE Pneumonia is most common infection after heart surgery
Pneumonia is the most common serious infection after heart surgery, according to research reported Nov. 15 at the American Heart Association’s Scientific Sessions 2011. Of more than 5,100 patients in a heart surgery registry, pneumonia occurred in 2.4 percent, and 43 percent of all major infections occurred after hospital discharge.

10. EVIDENCE Burden of early-onset neonatal sepsis remains high
November’s Pediatric Infectious Disease Journal contains “The Burden of Invasive Early-onset Neonatal Sepsis in the United States, 2005-2008,” which states that the burden remains “substantial” and “disproportionately affects preterm and black infants.”

11. EVIDENCE Simulation study day can improve ICU teamwork
A simulation-based study day “can improve teamwork in multidisciplinary critical care unit teams,” according to “The Effect of a Simulation-Based Training Intervention on the Performance of Established Critical Care Unit Teams.” In a full-day course, “using a mix of simulation-based learning and case-based learning seems to be an effective teaching strategy,” concludes the study in December’s Critical Care Medicine.

12. EVIDENCE New report urges greater integration of palliative care into ICU
Integrating Palliative Care in the Surgical and Trauma Intensive Care Unit: A Report From the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care,” published online Nov. 10 by Critical Care Medicine, concludes, “Approaches that emphasize delivery of palliative care together with surgical critical care hold promise to better integrate palliative care into the surgical intensive care unit.”

13. CALL TO ACTION Apply for funding to assess point-of-care ultrasound competency
The American Institute of Ultrasound in Medicine (AIUM), Laurel, Md., invites proposals for studies to assess competency for point-of-care applications of ultrasound. AIUM’s Endowment for Education and Research has allocated up to $50,000 for one or more grants. Learn more and apply by Thursday, March 1, 2012.

14. CALL TO ACTION Comment on FDA’s proposed opioid training program
The U.S. Food and Drug Administration (FDA), Silver Spring, Md., invites comments on the “Draft Blueprint for Prescriber Education for Long-Acting/Extended-Release Opioid Class-Wide Risk Evaluation and Mitigation Strategy.” Deadline: Wednesday, Dec. 7.

15. MEMBER BENEFIT Free enrollment in ChangeAnything.com for one year
Take control of the sources of influence that impact your behavior by becoming both the subject and the scientist of your change. In partnership with Change Anything, a division of VitalSmarts, AACN welcomes members to ChangeAnything.com — a social media website based on award-winning research. Sign up by Saturday, Dec. 31 for free one-year premium membership in this unique online resource.

16. CLINICAL PRACTICE RESOURCES
Patient Safety
On Nov. 21, the U.S. Food and Drug Administration, Silver Spring, Md., announced it is allowing marketing of the first system for repairing a failed or problematic aortic endograft — Aptus EndoStapling System, manufactured by Aptus Endosystems Inc., Sunnyvale, Calif.

17. AACN RESOURCES
Buy your holiday gifts online
This holiday season support AACN by purchasing one or more holiday gifts online, such as:
-- “A Daybook for Critical Care Nurses” to inspire a favorite co-worker or mentor
-- AACN ceramic to-go mug for a coffee drinker
-- AACN logo baseball caps for your softball team
-- CCNS business card case for a certified nurse colleague

Find jobs at NursePath.com
Are you a recent graduate? Or are you a mid- or senior-career acute or critical care nurse looking to change jobs or locations? Visit NursePath.com, AACN’s online career site, to find employment opportunities in high acuity and critical care across the U.S.

Notable Quote
“Colleagues can be your best allies. They can help you sort out some of your big and small questions. Learn from others’ experiences and value stories for the lessons they teach. A successful CNS has often spent years learning to stay focused, manage time, prioritize projects, and avoid overcommitment.” — Katie Brush, “Clinical Nurse Specialist Toolkit: A Guide for the New Clinical Nurse Specialist.”

Together. Stronger. Bolder.
From November’s AACN Bold Voices
One Size Doesn’t Fit All ” — Mary Stahl, AACN President 2011-2012
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