Critical Care eNewsline — January 10, 2013

NEWS - FDA approves Eliquis for certain patients

ACTION - Reserve hotel room for NTI 2013

ACTION - Register for 'A Slice of AACN NTI'

EVIDENCE - High-dose norepinephrine futile in some patients

RESOURCES - Guidelines for insulin infusions in ICU patients

"B Is for Balance: A Nurse's Guide for Enjoying Life at Work and at Home,"
by Sharon Weinstein

Submit nominations for AACN President's Award for Chapters

Nominate chapters for the 2013 AACN President's Award for Chapters, which recognizes exemplary efforts to further AACN's mission, vision and values. Nominations close Friday, Feb. 15. Learn more and nominate.

Register for 'A Slice of AACN NTI'

Register for the fourth annual "A Slice of AACN NTI," April 1-5, MGM Grand, Las Vegas. Nationally recognized faculty from AACN's National Teaching Institute & Critical Care Exposition (NTI) will share their expertise in high acuity and critical care. Earn up to 14 CNE hours for the preconferences and up to 17.75 CNE hours for the main conference, while networking with your colleagues from across the country. Early-bird registration discount ends Feb. 25.

Reserve hotel room to attend NTI 2013 in Boston

AACN Housing is accepting hotel reservations for the annual National Teaching Institute & Critical Care Exposition (NTI) in Boston, May 18-23. Discounted rates are available until April 2, but early booking is strongly advised to ensure the best selection. Register online or call (800) 340-1840.

Participate in study on nurse turnover

Minnie Major, a doctoral student at Capella University, Minneapolis, is conducting a study to learn what nurses think about voluntary turnover in the hospital setting. Participate by completing the survey. Email Major with questions.

High-dose norepinephrine futile in some patients, study in AJCC says

"High-Dose Norepinephrine Treatment: Determinants of Mortality and Futility in Critically Ill Patients," in January's American Journal of Critical Care (AJCC), finds that the cause of shock and treatment with norepinephrine did not predict death when high doses of the drug were used, but rescue treatment with high-dose norepinephrine is futile in patients with severe disease and metabolic acidemia.

CNE article in AJCC: Depression screening in patients with ACS

"Depression Screening: Utility of the Patient Health Questionnaire in Patients With Acute Coronary Syndrome," a continuing nursing education (CNE) article in January's American Journal of Critical Care (AJCC), finds that for depression screening in hospitalized patients with acute coronary syndrome (ACS), a nurse-administered Patient Health Questionnaire 2 is as accurate as longer versions of the screening tool.

Blood transfusion associated with higher mortality in patients with MI

"Association of Blood Transfusion With Increased Mortality in Myocardial Infarction (MI): A Meta-analysis and Diversity-Adjusted Study Sequential Analysis," published online Dec. 24, 2012, by JAMA Internal Medicine, notes, "Blood transfusion or a liberal blood transfusion strategy compared with no blood transfusion or a restricted blood transfusion strategy is associated with higher all-cause mortality rates" in patients with MI who have anemia.

Longer IV infusion of carbapenems and piperacillin/tazobactam associated with lower mortality than short-term infusion

"Clinical Outcomes With Extended or Continuous Versus Short-term Intravenous Infusion of Carbapenems and Piperacillin/Tazobactam: A Systematic Review and Meta-analysis" suggests that extended or continuous infusion is associated with lower mortality in patients, but "well-designed randomized controlled trials are warranted to confirm these findings before such approaches become widely used," concludes the study in the Jan. 15 Clinical Infectious Diseases.

Study identifies risk factors for PICC CRBSIs

Patient- and Device-Specific Risk Factors for Peripherally Inserted Central Venous Catheter-Related Bloodstream Infections" (PICC CRBSIs) include heart failure, intra-abdominal perforation, recent chemotherapy, presence of tracheostomy and multiple-lumen catheter, according to the study published online Dec. 14, 2012, by Infection Control & Hospital Epidemiology.

Evidence-based tools can help prevent hemodynamic instability during mobility

"Understanding Critically Ill Patients Hemodynamic Response to Mobilization: Using the Evidence to Make It Safe and Feasible," in January/March's Critical Care Nursing Quarterly, includes "evidence-based tools and techniques to help clinicians prevent hemodynamic instability before, during, and after in-bed or out-of-bed mobilization."

FDA approves Eliquis to reduce stroke risk in patients with non-valvular AF

On Dec. 28, 2012, the U.S. Food and Drug Administration, Silver Spring, Md., approved Eliquis (apixaban), manufactured by Bristol-Myers Squibb (BMS), Princeton, N.J., to reduce the risk of stroke and systemic embolism in patients with atrial fibrillation (AF) not caused by heart valve disease. BMS notified clinicians to read the prescribing recommendations on how to convert patients on Eliquis to warfarin or other anticoagulants, because discontinuing Eliquis without adequate continuous anticoagulation increases the risk of stroke.

Revised guidelines for managing pain, agitation and delirium in ICU patients

Access "Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit" in January's Critical Care Medicine.

Guidelines for insulin infusions in ICU patients with hyperglycemia

Access "Guidelines for the Use of an Insulin Infusion for the Management of Hyperglycemia in Critically Ill Patients" in December 2012's Critical Care Medicine.

Revised statement on screening for retinopathy of prematurity

January's Pediatrics contains a revised policy statement, "Screening Examination of Premature Infants for Retinopathy of Prematurity," from the American Academy of Pediatrics, Elk Grove Village, Ill.

AACN's new ACNPC-AG certification

Apply to take the exam for ACNPC-AG, AACN's new certification for adult-gerontology acute care nurse practitioners. ACNPC-AG is an entry-level advanced practice certification in alignment with the "Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education." To better prepare for the exam, register for AACN's new ACNPC-AG certification review course, available on-demand (streaming from AACN's website). The course reflects the ACNPC-AG test plan and is offered free of charge to individuals who purchase the exam.

Dare To

From January's AACN Bold Voices
"Dare to Let Go"— Kathryn Roberts, AACN President 2012-2013