Critical Care Newsline — January 6, 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.

January 6, 2011

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1. EVIDENCE Take Heart America program doubles cardiac arrest survival
2. EVIDENCE pCAM-ICU tool reliable, valid for diagnosing delirium in children
3. EVIDENCE Blood transfusion after peds cardiac surgery prolongs hospital stay
4. EVIDENCE Patients want clear roles for nurses in primary care practice
5. CALL TO ACTION Register for National Nursing Ethics Conference
6. CALL TO ACTION Survey on ICU nurses and EOL decision making
7. CALL TO ACTION Apply to attend AONE’s Aspiring Nurse Leader Institute
8. CALL TO ACTION Participate in ACNPC and CCNS Studies of Practice surveys
9. CALL TO ACTION Apply for HHS-CCSC HAI Award
10. CLINICAL PRACTICE RESOURCES
11. AACN RESOURCES Make Good on Your Resolutions

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1. EVIDENCE Take Heart America program doubles cardiac arrest survival
The Take Heart America program — a community-based initiative for deploying the most highly recommended 2005 American Heart Association, Dallas, resuscitation guidelines — “doubled cardiac arrest survival when compared with historical controls” in two Minnesota sites, according to January’s Critical Care Medicine. “Study of the feasibility of generalizing this approach to larger cities, states, and regions is underway,” concludes “Take Heart America: A Comprehensive, Community-Wide, Systems-Based Approach to the Treatment of Cardiac Arrest.”

2. EVIDENCE pCAM-ICU tool reliable, valid for diagnosing delirium in children
Diagnosing Delirium in Critically Ill Children: Validity and Reliability of the Pediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU)” reports the method is a “highly valid reliable instrument for the diagnosis of pediatric delirium in critically ill children chronologically and developmentally at least 5 yrs of age.” The pCAM-ICU “may expedite diagnosis and consultation with neuropsychiatry specialists for treatment of pediatric delirium,” states the study of 68 patients in January’s Critical Care Medicine.

3. EVIDENCE Blood transfusion after peds cardiac surgery prolongs hospital stay
Blood Transfusion After Pediatric Cardiac Surgery Is Associated With Prolonged Hospital Stay,” states a study in January’s Annals of Thoracic Surgery. Patients undergoing biventricular procedures had the highest risk for increased length of stay.

4. EVIDENCE Patients want clear roles for nurses in primary care practice
Patients with multiple morbidities believe nurses in primary care practice are competent and could increase accessibility to care, but they want “clear definitions of professional roles and fields of practice” between nurses and physicians, according to “Nurses Joining Family Doctors in Primary Care Practices: Perceptions of Patients With Multimorbidity,” a study of 18 patients published online Nov. 4, 2010 by BMC Family Practice.

5. CALL TO ACTION Register for National Nursing Ethics Conference
The National Nursing Ethics Conference, which takes place March 24-25 in Los Angeles and Universal City, Calif., provides nurses with information on how to balance their values and those of the profession with appropriate goals of care, limited resources, professional responsibility and advocacy as stated in the Code of Ethics for Nurses by American Nurses Association, Alexandria, Va. The conference is also a platform where practicing nurses can share their experiences with one another. Early-bird registration ends Jan. 14.

6. CALL TO ACTION Survey on ICU nurses and EOL decision making
Participate in the research study “Nurses’ Involvement in End-of-Life (EOL) Decision-Making in the Intensive Care Unit” — an investigation of the prevalence and predictors of ICU nurses’ active involvement in EOL decision making. Complete the online survey and opt to participate in a “thank you” drawing for a $150 Visa gift card.

7. CALL TO ACTION Apply to attend AONE’s Aspiring Nurse Leader Institute
The American Organization of Nurse Executives (AONE) holds its semiannual Aspiring Nurse Leader Institute Monday, June 20 through Thursday, June 23, 2011, in Indianapolis. Apply for an AACN Continuing Professional Development Scholarship to attend. Qualified applicants must be current members of both AACN and AONE. Visit AACN’s special interest scholarships page for details on eligibility and application requirements. Learn more about additional AACN special interest scholarships that help members attend evidence-based nursing practice programs.

8. CALL TO ACTION Participate in ACNPC and CCNS Studies of Practice surveys
AACN Certification Corporation is conducting two national Studies of Practice to collect evidence-based information to update ACNPC and CCNS test plans, inform the “Scope and Standards of Practice for the Acute Care Nurse Practitioner” and enhance resources for advanced practice nurses. Acute care and gerontology nurse practitioners are invited to participate in the ACNPC Study of Practice. CCNSs and adult, gerontology and pediatric CNSs are invited to participate in the CCNS Study of Practice. Each survey takes about 30 minutes to complete. Participants will be entered into a drawing to win one of four regional gift cards and main conference registration for the 2011 National Teaching Institute & Critical Care Exposition, Chicago, which takes place Saturday, April 30 through Thursday, May 5. Survey deadline is Jan. 31.

9. CALL TO ACTION Apply for HHS-CCSC HAI Award
Is your hospital making strides in eradicating healthcare-associated infections (HAIs)? If so, apply for new national awards recognizing long-term reduction or elimination of HAIs, a leading cause of death in the U.S. Apply by Saturday, Jan. 29. Visit www.aacn.org/hhs-ccsc-award for complete details on eligibility, selection criteria and application requirements.

10. CLINICAL PRACTICE RESOURCES
Patient safety
On Dec. 23, 2010, ev3, Plymouth, Minn., announced its voluntary recall of certain lots of the NanoCross .014-inch OTW PTA Dilatation Catheter because of potential cracking or breaking.

In December 2010, American Regent, Inc., Shirley, N.Y., and the U.S. Food and Drug Administration, Silver Spring, Md., recalled lots of Dexamethasone Sodium Phosphate Injection multiple dose vials because some contain particulates or might form particulates before the expiration date and lots of Sodium Bicarbonate Injection vials because some contain particulates.

On Dec. 29, 2010, the U.S. Food and Drug Administration, Silver Spring, Md., posted a recall of Arrow Ultra 8 Intra-Aortic Balloon Catheters (IABS) 8 FR 30CC and 40CC Universal and the Arrow Intra-Aortic Balloon (IAB) Catheter with a Fiber Optic Sensor and a Measurement System, because the catheters can become stuck in the sheath. Arrow International, Inc., Everett, Mass., started the recall Oct. 11, 2010.

Evidence
Critical Care Medicine recently published two ICU-relevant infection control studies. January’s “Inappropriate Antibiotic Therapy in Gram-Negative Sepsis Increases Hospital Length of Stay” found one-third of patients first receive inappropriate therapy. “Candida Bloodstream Infections in Intensive Care Units: Analysis of the Extended Prevalence of Infection in an Intensive Care Unit Study,” published online Dec. 16, states, “Candidemia remains a significant problem” in ICU patients. “Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use,” concludes the retrospective analysis.

Resource
Access slides and audio for “Influenza Preparedness in the Pediatric Population” from the Centers for Disease Control and Prevention, Atlanta, which discusses recommendations for prevention and treatment of influenza in children and reviews strategies to improve emergency preparedness response.

Guidelines
Jan. 1’s Stroke contains “Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.”

Access “Guidance for Clinicians on the Use of Rapid Influenza Diagnostic Tests for the 2010-2011 Influenza Season” from the Centers for Disease Control and Prevention, Atlanta.

11. AACN RESOURCES
Make Good on Your Resolutions
Wishing you a Happy New You in the new year! What are your New Year’s resolutions? Are they to achieve mental balance, get fit, better your work performance or gain more inner strength to handle difficult situations? Browse our wellness products at www.aacn.org/newyou.

Speak boldly with AACN Practice Alerts
AACN Practice Alerts are concise, action-oriented and evidence-based statements about acute and critical care nursing practices that help nurses carry their bold voices to the bedside. Learn more; access alerts.

Stand Tall: AACN Bold Voices
Without it you’re a yawn. — Kristine Peterson, AACN President 2010-2011

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