Critical Care Newsline — July 21, 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.

July 21, 2011

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1. COMING SOON AACN website gets new look and feel
2. CALL TO ACTION 2012 AACN Circle of Excellence Award nominations close Aug. 1
3. CALL TO ACTION Share certification best practices, qualify as NTI panelist
4. CALL TO ACTION Participate in research utilization survey
5. RESOURCE Discounts on VitalSmarts workshops for AACN members
6. EVIDENCE Revascularization doesn’t improve in-hospital VT/VF arrest survival
7. EVIDENCE NEJM study doesn’t recommend nesiritide for routine use in HF
8. EVIDENCE High-dose dexmedetomidine less likely to meet sedation goals
9. EVIDENCE CHEST reports study of oxygen for COPD air-travel patients
10. CALL TO ACTION Comment on TJC’s proposed pediatric EPs
11. CALL TO ACTION Save Nov. 9-12 for Progressive Care Pathways conference
12. NEWS Critical Care Societies Collaborative sets ICU telemedicine research agenda
13. CLINICAL PRACTICE RESOURCES
14. AACN RESOURCES Look for jobs at NursePath.com
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1. COMING SOON AACN website gets new look and feel
In the near future, you will notice changes to the AACN website, which will include a wider design, easier access to popular and relevant resources, and quick links to features from a new sidebar column. Look for these changes soon, and enjoy the newly enhanced user experience.

2. CALL TO ACTION AACN Circle of Excellence Award nominations close Aug. 1
Do you know a peer who makes a difference in the lives of patients and families? Nominate him or her for a 2012 AACN Circle of Excellence Award. Up to 25 recipients will be selected to receive a $1,000 honorarium and be inducted into the Circle of Excellence Society. Nominations close Monday, Aug. 1. Learn more and nominate.

3. CALL TO ACTION Share certification best practices, qualify as NTI panelist
If your facility or chapter has successfully implemented certification best practices — strategies to encourage, recognize and reward certification, submit your story online by Friday, Sept. 30. AACN will select the two most innovative practices for panel presentation during the “Creating a Culture of Certification: Best Practices Roundtable” at the 2012 National Teaching Institute & Critical Care Exposition (NTI), Saturday through Thursday, May 19-24, Orlando, Fla. AACN Certification Corporation accepts best-practices submissions year-round, which are available to view online.

4. CALL TO ACTION Participate in research utilization survey
Contributing to nursing research is an important part of our professional practice. The KAP — Knowledge, Attitudes and Practice — Research Utilization Survey with 33 questions will help improve the teaching steps of research utilization. Please take about 15 minutes to participate anonymously.

5. RESOURCE Discounts on VitalSmarts workshops for AACN members
AACN members save 20 percent on registration for the “Crucial Conversations,” “Crucial Confrontations” and “Influencer Training” two-day workshops sponsored by VitalSmarts, Provo, Utah. Learn best practices and tools for managing high-stakes interactions in “Crucial Conversations.” Get step-by-step processes to identify and resolve performance gaps in “Crucial Confrontations” and gain knowledge about creating positive, lasting change in your organization with “Influencer Training.” Find a scheduled workshop near you. Enter the code “AACN20” to receive the discount at checkout.

6. EVIDENCE Revascularization doesn’t improve in-hospital VT/VF arrest survival
Outcomes of Cardiac Catheterization and Percutaneous Coronary Intervention for In-hospital VT/VF (Ventricular Tachycardia/Ventricular Fibrillation) Cardiac Arrest” states that “an aggressive revascularization strategy” did not improve survival or neurological outcomes. “Further studies are necessary to identify potential subgroups that may benefit from revascularization,” concludes the study published online July 6 by Catheterization and Cardiovascular Interventions.

7. EVIDENCE NEJM study doesn’t recommend nesiritide for routine use in HF
“Nesiritide cannot be recommended for routine use in the broad population of patients with acute heart failure (HF),” concludes a randomized study of 7,141 patients in July 7’s New England Journal of Medicine (NEJM). Compared to placebo, nesiritide did not reduce mortality and was associated with higher rates of hypotension, states “Effect of Nesiritide in Patients With Acute Decompensated Heart Failure.”

8. EVIDENCE High-dose dexmedetomidine less likely to meet sedation goals
High-dose dexmedetomidine (more than 7 mcg/kg/h) is significantly less likely than lower doses to achieve sedation goals according to “High-dose Dexmedetomidine for Sedation in the Intensive Care Unit: An Evaluation of Clinical Efficacy and Safety,” a retrospective study of 133 patients in June’s Annals of Pharmacotherapy.

9. EVIDENCE CHEST reports study of oxygen for COPD air-travel patients
July’s CHEST states that compressed oxygen with continuous flow or an oxygen-conserving device are equally effective for patients with chronic obstructive pulmonary disease (COPD) who need to travel by air, and both are more effective than a portable oxygen concentrator. “COPD and Air Travel: Oxygen Equipment and Preflight Titration of Supplemental Oxygen” also reports that the hypoxia-altitude simulation test can be used to identify patients who need supplemental oxygen.

10. CALL TO ACTION Comment on TJC’s proposed pediatric EPs
Comment on proposed new and revised pediatric elements of performance (EPs) from The Joint Commission (TJC), Oakbrook Terrace, Ill., by Thursday, Aug. 18. Areas identified: “medication management, pain management, patient safety and security, competency specific to the provision of care to pediatric patients, transitioning pediatric patients to adult care, and patient falls,” TJC states.

11. CALL TO ACTION Save Nov. 9-12 for Progressive Care Pathways conference
Do you work in progressive care, including intermediate care, direct observation, stepdown, telemetry, transitional or emergency care? Do you work in a medical-surgical area of a hospital that doesn’t have progressive care? Then mark your calendar for Nov. 9-12 to attend the AACN Progressive Care Pathways conference in Las Vegas. Request a brochure.

12. NEWS Critical Care Societies Collaborative sets ICU telemedicine research agenda
The Research Agenda in ICU Telemedicine: A Statement From the Critical Care Societies Collaborative” in July’s CHEST recommends that future research address causation rather than “simply associations” and highlight action mechanisms “to determine exactly how ICU telemedicine achieves its effects.” The collaborative proposes “an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care.”

13. CLINICAL PRACTICE RESOURCES
Patient Safety
July’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices, Horsham, Pa., announces the institute’s partnership with Diabetes In Control, an online resource for medical professionals. The article contains several examples from the “Diabetes Disaster Averted” column. Read past issues.

Evidence
In June, Annals of Thoracic Surgery published two studies online. “Comparing Long-Term Survival Between Patients Undergoing Off-Pump and On-Pump Coronary Artery Bypass Graft (CABG) Operations” published June 28, states patients who had off-pump CABG had a higher risk of long-term mortality. “Daily Chest Roentgenograms Are Unnecessary in Nonhypoxic Patients Who Have Undergone Pulmonary Resection by Thoracotomy,” published June 23, concludes daily chest x-rays (CXRs) are “of little benefit for patients who do not have a pneumothorax on their recovery room CXR or for patients who do not become hypoxic.”

On June 23, Critical Care Medicine published two studies about biomarkers online. “Evaluation of New Acute Kidney Injury Biomarkers in a Mixed Intensive Care Unit” states urinary biomarkers have a significant and “moderately predictive” use for diagnosing kidney injury and “urinary L-type fatty acid-binding protein, and neutrophil gelatinase-associated lipocalin can serve as new biomarkers of mortality prediction in critical care.” Inflammatory biomarkers can help identify patients who need to be admitted to the ICU, according to “Inflammatory Biomarkers and Prediction for Intensive Care Unit Admission in Severe Community-acquired Pneumonia,” which adds, “Patients with severe community-acquired pneumonia by minor criteria and low levels of procalcitonin may be safely admitted to wards.”

14. AACN RESOURCES
Look for jobs at NursePath.com
Visit NursePath.com, AACN’s online career site, to find employment opportunities in high acuity and critical care across the U.S.

AACN Bold Voices
Together. Stronger. Bolder. — Mary Stahl, AACN President 2011-2012

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