Critical Care Newsline — December 8, 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. 8, 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. CALL TO ACTION Join world-famous Nurses’ Health Study
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 Risk factors for catheter-related thrombosis identified
10. EVIDENCE Pneumonia is most common infection after heart surgery
11. CALL TO ACTION Apply for funding to assess point-of-care ultrasound competency
12. MEMBER BENEFIT Free enrollment in ChangeAnything.com for one year
13. CLINICAL PRACTICE RESOURCES
14. 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 psychologically. 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
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 the use of pre- and post-catheterization assessments to gauge proper catheter use and to monitor 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. CALL TO ACTION Join world-famous Nurses’ Health Study
Are you between 20 and 46 years old? If so, join the world-famous Nurses’ Health Study (NHS) 3 to contribute to groundbreaking research on lifestyle, environment, nurses’ worklife and women’s health. NHS 3 builds on the two previous Nurses’ Health Studies, which enrolled more than 230,000 women combined. Participation requires only one hour of your time each year. Recruitment continues until 100,000 participants are enrolled. JoAnn Grif Alspach’s editorial in December’s Critical Care Nurse also addresses this study.

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 — sponsored by AACN, its partnering organizations in the Critical Care Societies Collaborative (CCSC) and U.S. Department of Health and Human Services (Office of Healthcare Quality/Office of the Assistant Secretary for Health) — emphasizes 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 for 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 Risk factors for catheter-related thrombosis identified
Risk Factors Associated With Peripherally Inserted Central Venous Catheter-related Large Vein Thrombosis in Neurological Intensive Care Patients” include catheter placement in a paretic arm, surgery longer than one hour during catheter dwell time, mannitol use and history of venous thromboembolism, according to a study published online Nov. 24 by Intensive Care Medicine.

10. EVIDENCE Pneumonia is most common infection after heart surgery
Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization and Risk of Subsequent Infection in Critically Ill Children: Importance of Preventing Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission” states, “Although MRSA colonized children may have lower risks of subsequent infection than adults, children who acquire MRSA in the hospital have similarly high rates of infection.” The study in the Dec. 15 Clinical Infectious Diseases concludes, “Preventing transmission of MRSA in hospitalized children should remain a priority.”

11. 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.

12. 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.

13. CLINICAL PRACTICE RESOURCES
Patient Safety
On Nov. 30, the U.S. Food and Drug Administration, Silver Spring, Md., approved the first generic version of Lipitor (atorvastatin calcium tablets), manufactured by Ohm Laboratories, New Brunswick, N.J.

14. 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 Nurse Educators” to inspire an OR nurse educator
-- AACN pins so nurses can show their pride
-- AACN water bottle for a fitness buff
-- CCRN lunch cooler 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
“The tact in managing crises is an example of the skilled know-how and embodied intelligence vital to expert critical care nursing. This skilled clinical knowledge is founded on and organized by the clinician’s perceptual acuity and those recognitional skills must be linked with a rapid and apt response. Skilled clinical know-how, clinical wisdom, and good judgment are linked in the process of becoming an expert clinician.” — Patricia Benner, Patricia Hooper Kyriakidis and Daphne Stannard, “Clinical Wisdom and Interventions in Acute and Critical Care: A Thinking-in-Action Approach, 2nd Ed.

Together. Stronger. Bolder.
From December’s AACN Bold Voices
Embrace Conflict. Really?” — Mary Stahl, AACN President 2011-2012
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