Critical Care Newsline — November 3, 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.

Nov. 3, 2011

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1. NEWS Eli Lilly and Company announces market withdrawal of Xigris
2. NEWS Bedside barcode scanning doesn’t eliminate errors, ISMP warns
3. CALL TO ACTION Apply for HHS-CCSC HAI award
4. EVIDENCE Nurses often fail to recognize delirium, study says
5. CALL TO ACTION Submit nominations for AACN President’s Award for Chapters
6. RESOURCE Access free webinar on TPN bacterial outbreak
7. EVIDENCE HF patients at high risk of death
8. EVIDENCE Children with surgical-cardiac disease more likely to survive in-hospital cardiac arrest
9. CALL TO ACTION Participate in survey about RNs and work/family responsibilities
10. MEMBER BENEFIT AACN members save money on VitalSmarts workshops
11. MEMBER BENEFIT New edition of best-selling book ‘Crucial Conversations’ available
12. MEMBER BENEFIT Free enrollment in ChangeAnything.com for one year
13. CLINICAL PRACTICE RESOURCES
14. AACN RESOURCES Find jobs at NursePath.com
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1. NEWS Eli Lilly and Company announces market withdrawal of Xigris
The U.S. Food and Drug Administration is informing healthcare professionals and the public that Oct. 25, 2011, Eli Lilly and Company announced a worldwide voluntary market withdrawal of Xigris [drotrecogin alfa (activated)]. In a recent study, Xigris failed to show a survival benefit for patients with severe sepsis and septic shock.

2. NEWS Bedside barcode scanning doesn’t eliminate errors, ISMP warns
October’s Nurse Advise-ERR, published by the Institute for Safe Medication Practices (ISMP), Horsham, Pa., warns that drug, dose and time errors can still occur with a bedside barcode scanning system, partly because the same audible beep is heard for correct and incorrect verification of patient and medication. Nurses can only differentiate the two by reading what is on the electronic medication administration record (eMAR) or the device’s screen. The article recommends addressing conditions when the eMAR is not available and educating users about the problem. Read past issues.

3. CALL TO ACTION Apply for HHS-CCSC HAI award
Apply by 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 (HHS), Office of the Assistant Secretary for Health, and Office of Healthcare Quality, emphasizing success related to reducing or eliminating central line-associated bloodstream infections and ventilator-associated pneumonia. Access eligibility, selection criteria and application requirements.

4. EVIDENCE Nurses often fail to recognize delirium, study says
According to “Nurses’ Recognition of Delirium in the Hospitalized Older Adult,” nurses treating acute care patients fail to recognize delirium 75 percent of the time when they use the Confusion Assessment Method (CAM). “Additional research is warranted regarding the clinical decision-making processes that nurses use in assessing acute cognitive changes and in identifying strategies to improve delirium recognition,” concludes the study in the November/December Clinical Nurse Specialist.

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

6. RESOURCE Access free webinar on TPN bacterial outbreak
Access the free webinar “Compounding Total Parenteral Nutrition (TPN) Preparations: A 2011 Investigation of a Bacterial Outbreak” from the Centers for Disease Control and Prevention, Atlanta, and the U.S. Pharmacopeia, Rockville, Md.

7. EVIDENCE HF patients at high risk of death
Long-Term Follow-up of Participants With Heart Failure in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)” found that patients who developed heart failure (HF) had a high risk of death across all treatment groups in the trial. “Measures to prevent the development of HF, especially blood pressure control, must be a priority if mortality associated with the development of HF is to be addressed,” concludes the study, published online Oct. 3 by Circulation.

8. EVIDENCE Children with surgical-cardiac disease more likely to survive in-hospital cardiac arrest
“Children with surgical-cardiac disease have significantly better survival to hospital discharge after an in-hospital cardiac arrest compared with children with medical-cardiac disease and noncardiac disease,” concludes “Outcomes After In-Hospital Cardiac Arrest in Children With Cardiac Disease: A Report From Get With the Guidelines–Resuscitation,” published online Oct. 24 by Circulation.

9. CALL TO ACTION Participate in survey about RNs and work/family responsibilities
You are invited to participate in an online survey about RNs who manage both work and family responsibilities. Doctoral student Leanne Clark-Shirley from University of Maryland, Baltimore County, requests your answers to questions about your job, co-workers and whether you help to care for older family members or friends. You must be an RN and a current member of AACN to participate. This important, confidential survey will help AACN and other nursing organizations better understand how RNs find a balance between work and family needs. Everyone who participates is eligible for a drawing for one of three $50 Amazon.com e-gift cards. Take the survey.

10. MEMBER BENEFIT AACN members save money on VitalSmarts workshops
AACN members who register for two-day workshops sponsored by VitalSmarts, including “Crucial Conversations,” “Crucial Confrontations” and “Influencer Training,” save 20 percent on the price of each. “Crucial Conversations” offers best practices for high-stakes interactions. “Crucial Confrontations” equips participants with step-by-step processes to identify and resolve performance gaps. “Influencer Training” teaches the ideal combination of strategies and skills designed to create positive, lasting change. Learn more and find a scheduled workshop near you. AACN members must enter the code “AACN20” to receive the discount applied at checkout on the VitalSmarts website.

11. MEMBER BENEFIT New edition of best-selling book ‘Crucial Conversations’ available
The second edition of The New York Times’ best-selling book “Crucial Conversations: Tools for Talking When Stakes Are High” summarizes new research, inspires readers with powerful stories that illustrate key principles and provides links to videos that demonstrate effective ways to conduct crucial conversations. AACN members receive a discount on their purchase.

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 Dec. 31 for free one-year premium membership in this unique online resource.

13. CLINICAL PRACTICE RESOURCES
Patient Safety
On Oct. 21, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced that most cases of serotonin syndrome with Zyvox (linezolid), manufactured by Pfizer, New York, occur in patients taking a selective serotonin reuptake inhibitor or a serotonin norepinephrine reuptake inhibitor and added that Zyvox should be avoided in all patients taking serotonergic drugs. The FDA also announced that most cases of serotonin syndrome in patients given serotonergic psychiatric medications — particularly selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors or clomipramine — and methylene blue occur with parathyroid surgery, during which intravenous methylene blue is used as a visualizing agent.

Resource
Download slides from “Risk Evaluation and Mitigation Strategies (REMS),” a webinar presented Oct. 24 by the U.S. Food and Drug Administration, Silver Spring, Md.

14. AACN RESOURCES
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
“Bundle branch block by itself is not an indication for pacing. However, if a patient has symptoms such as syncope, further investigation is warranted to determine whether AV block or arrhythmias such as VT are responsible for the symptoms, because many of these patients have structural heart disease.” — Anne B. Curtis. “Fundamentals of Cardiac Pacing.”

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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