Critical Care Newsline — June 30, 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.

June 30, 2011

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1. NEWS CDC issues measles health advisory
2. CALL TO ACTION Save Nov. 9-12 for progressive care conference
3. EVIDENCE Prolonged ED diversion increases AMI mortality, JAMA study states
4. CALL TO ACTION U.S. Critical Illness and Injury Trials Group annual fall meeting
5. EVIDENCE Pediatric ICU thromboprophylaxis is inconsistent, study states
6. EVIDENCE Serum creatinine may help predict AKI
7. EVIDENCE Non-invasive CO monitoring doesn’t improve early hemodynamic stability
8. CALL TO ACTION Live PCCN Certification Review webinar starts July 25
9. CALL TO ACTION Enter the NTI 2012 Guest Emcee Contest by Dec. 1
10. RESOURCE Public-private partnership aims to improve safety, quality
11. DISCUSSION How do you ensure completely relieved breaks?
12. CLINICAL PRACTICE RESOURCES
13. AACN RESOURCES Look for jobs at NursePath.com
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1. NEWS CDC issues measles health advisory
In the U.S., from Jan. 1 to June 17, there were a reported 156 measles cases — the highest number since 1996. Most of them “involved unvaccinated U.S. residents who recently traveled abroad, unvaccinated visitors to the United States, and people linked to these imported cases,” states a June 22 health advisory from the Centers for Disease Control and Prevention (CDC), Atlanta. For healthcare providers, CDC recommends ensuring current measles, mumps and rubella (MMR) vaccination and reporting measles cases to local health departments.

2. CALL TO ACTION Save Nov. 9-12 for progressive care 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.

3. EVIDENCE Prolonged ED diversion increases AMI mortality, JAMA study states
Emergency department (ED) ambulance diversion of at least 12 hours increases mortality in patients with acute myocardial infarction (AMI), according to “Association Between Ambulance Diversion and Survival Among Patients With Acute Myocardial Infarction,” published online June 12 by The Journal of the American Medical Association (JAMA). The study of 11,625 Medicare patients found that shorter diversion times did not affect mortality.

4. CALL TO ACTION U.S. Critical Illness and Injury Trials Group annual fall meeting
Attend the annual fall meeting of the U.S. Critical Illness and Injury Trials Group (USCIITG), which facilitates collaboration among experts to promote clinical trials in critically ill or injured patients, Tuesday and Wednesday, Nov. 8 and 9, Bethesda, Md. Committed to establishing a critical care research consortium, USCIITG supported AACN’s 2009 efforts with the Critical Care Societies Collaborative to develop clinical management guidelines for sepsis as part of the 2009 Surviving Sepsis Campaign. For more information, contact Kellie Keane, administrative coordinator, at (617) 643-7386 or email usciitgroup@partners.org.

5. EVIDENCE Pediatric ICU thromboprophylaxis is inconsistent, study states
Survey of Pharmacologic Thromboprophylaxis in Critically Ill Children” reports physicians are more likely to prescribe thromboprophylaxis to adolescents than children or infants, but prescribe it less often in adolescents than recommended by evidence-based guidelines for adults. “The heterogeneity in practice we documented underscores the need for rigorous randomized trials to determine the need for thromboprophylaxis in critically ill adolescents and children,” concludes the study in July’s Critical Care Medicine.

6. EVIDENCE Serum creatinine may help predict AKI
Increased serum creatinine (SCr) may predict acute kidney injury (AKI), which increases morbidity and mortality in critically ill children, according to “Acute Kidney Injury Is an Independent Risk Factor for Pediatric Intensive Care Unit Mortality, Longer Length of Stay and Prolonged Mechanical Ventilation in Critically Ill Children: A Two-Centre Retrospective Cohort Study.” “Paying attention to small early SCr rises may contribute to early AKI diagnosis in conjunction with other new AKI biomarkers,” concludes the retrospective study published online June 10 by Critical Care.

7. EVIDENCE Non-invasive CO monitoring doesn’t improve early hemodynamic stability
Adding minimally invasive cardiac output (CO) monitoring to usual care doesn’t help achieve hemodynamic stability within six hours or improve outcomes, according to “Early Non-invasive Cardiac Output Monitoring in Hemodynamically Unstable Intensive Care Patients: A Multi-center Randomized Controlled Trial,” published online June 10 by Critical Care.

8. CALL TO ACTION Live PCCN Certification Review webinar starts July 25
Register today for the multi-session PCCN Certification Review Course live webinar. Offering 14.5 contact hours of continuing education credit, the course features practice questions, live polling and text chat with Carol Rauen, an independent clinical nurse specialist and education consultant who presents the webinar. AACN Certification Reviews Online offers this webinar, which covers cardiovascular, pulmonary, neurologic, renal, gastrointestinal, multisystem, hematology/immunology, behavioral considerations, the AACN Synergy Model and test-taking tips. Internet access is required to participate alone or with colleagues. Register early, as space is limited.

9. CALL TO ACTION Enter the NTI 2012 Guest Emcee Contest by Dec. 1
Have you ever given a great toast at a wedding? Announced a raffle winner at a party, read poetry out loud at a café or simply asked a question in front of peers at a meeting or in class?

Then you might just be a candidate for a guest emcee role at the 2012 National Teaching Institute & Critical Care Exposition (NTI). Submit a video by Thursday, Dec. 1, telling us why you’d make a great guest emcee at NTI 2012. Selected guest emcees receive a complimentary main conference registration, airfare and lodging at NTI in Orlando, Fla.

10. RESOURCE Public-private partnership aims to improve safety, quality
Access Partnership for Patients: Better Care, Lower Costs, a national public-private partnership launched in April by U.S. Health and Human Services, Washington, D.C., that is intended to improve the quality, safety and affordability of healthcare. By 2013, the partnership hopes to save 60,000 lives by reducing hospital-acquired conditions by 40 percent and to cut hospital readmissions by 20 percent through better transitions from hospitals to other care settings.

11. DISCUSSION How do you ensure completely relieved breaks?
An article on page 15 of July’s AACN Bold Voices talks about the effect of nurses’ schedules on patient outcomes. It notes that completely relieved breaks and alternatives to 12-hour shifts reduce sleep deprivation. How do you ensure completely relieved breaks in your hospital to contribute to optimal patient outcomes? Join the Facebook discussion.

12. CLINICAL PRACTICE RESOURCES
Patient Safety
On June 20, the U.S. Food and Drug Administration, Silver Spring, Md., announced Ortho-McNeil-Janssen Pharmaceuticals, Titusville, N.J., recalled two lots of Risperdal (risperidone) tablets because of an uncharacteristic odor thought to be caused by TBA (2,4,6 tribromoanisole), a non-toxic chemical preservative.

13. 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.

NTI 2011 webcasts, abstracts
View webcasts of select sessions from the 2011 National Teaching Institute & Critical Care Exposition (NTI) for the first time or relive the experience. Free continuing education credit is available for most webcasts including “Hemorrhagic Stroke: Aggressive Management and Optimal Outcomes” and “Multiple Organ Dysfunction Syndrome: Children in Crisis.” May’s American Journal of Critical Care contains the “2011 National Teaching Institute Research Abstracts.”

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