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October 3, 2013
NEWS - Health Insurance Marketplace
ACTION - Progressive mobility webinar
NEWS - Universal ICU decolonization
EVIDENCE - Tracheostomy care
Since the beginning of civilization the groundwork and expectations for nursing practice have been in a state of constant transformation in response to the personal, community, and global health needs of the times.”
“Nursing Leadership From the Outside In,” by Greer Glazer and Joyce Fitzpatrick (eds.)
Oct. 17: Progressive mobility webinar completes AACN’s PAD miniseries
Join AACN Thursday, Oct. 17 at 10 a.m. PT for “Executing Evidence-based Progressive Mobility in the ICU,” a free, live webinar presented by Cheryl Esbrook and Brenda Pun. The third and final program in a miniseries devoted to implementation of new pain, agitation and delirium (PAD) guidelines, this 30-minute webinar will discuss long-term outcomes of critical illness survivors, evidence supporting early progressive mobility in the ICU and common obstacles faced when implementing mobility programs. Learn more and register.
Oct. 30: Webinar focuses on identifying top alarm signals to manage
Register now for the Oct. 30 webinar on identifying the most important alarm signals to manage. This free webinar is the second in a seven-part series sponsored by AACN, Healthcare Technology Safety Institute (HTSI) and seven other industry leaders. HTSI is an initiative of the AAMI (Association for the Advancement of Medical Instrumentation) Foundation, Arlington, Va. The webinar series continues Dec. 3 with a discussion on how to manage alarms at the bedside.
Hospitals asked to participate in survey on NG feeding tubes
The New Opportunities for Verification of Enteral Tube Location (NOVEL) Project, sponsored by the American Society for Parenteral and Enteral Nutrition, Silver Spring, Md., invites hospitals to participate in a one-day prevalence study of nasogastric (NG) feeding tubes in infants and children. The information will aid research designed to better understand the risks of NG tube placement verification. Email Sharon Irving if your hospital would like to participate.
Apply by Oct. 18 for AACN scholarship to attend NIWI: March 30-April 1, 2014
The Nurse in Washington Internship (NIWI), held annually in Washington, D.C., teaches nurses how to advance healthcare agendas through the legislative process and influence policy at local and national levels. For the fifth consecutive year, AACN will award continuing professional development scholarships for AACN members who wish to attend the 2014 program, March 30 to April 1. You must register separately for NIWI. Access AACN scholarship information, and then apply for an AACN scholarship to attend NIWI, no later than Friday, Oct. 18. Email firstname.lastname@example.org with questions.
CNE article in CCN describes proper tracheostomy care
“Tracheostomy Care and Complications in the Intensive Care Unit,” a continuing nursing education (CNE) article in October’s Critical Care Nurse (CCN), describes proper tracheostomy care in the ICU, strategies for preventing complications and management of tracheostomy emergencies.
Specific criteria promotes prompt referral for palliative care
“Choosing and Using Screening Criteria for Palliative Care Consultation in the ICU: A Report From the Improving Palliative Care in the ICU (IPAL-ICU) Advisory Board” finds that use of specific criteria encourages proactive referral for palliative care consultation. Criteria should be tailored for a specific ICU, implemented through a process that involves key stakeholders and evaluated by appropriate measures, concludes the study in October’s Critical Care Medicine.
Critical Care published the following studies
“Pupillary Reflex Measurement Predicts Insufficient Analgesia Before Endotracheal Suctioning in Critically Ill Patients,” posted online July 24, finds that a pupil diameter variation equal to or greater than 5 percent during a tetanic stimulation of 20 mA is highly predictable for insufficient analgesia during endotracheal suctioning in patients who are mechanically ventilated and deeply sedated.
“Relationship Between Extravascular Lung Water and Severity Categories of Acute Respiratory Distress Syndrome by the Berlin Definition,” posted online June 20, concludes the categories have “good predictive validity and may be associated with increased extravascular lung water and pulmonary vascular permeability.”
Health Insurance Marketplace
As the Affordable Care Act (ACA) enters its next phase with the Health Insurance Marketplace opening this week (Oct. 1) for enrollments, the Health Resources and Services Administration (U.S. Department of Health and Human Services) has launched a Provider Marketplace Toolkit to help you answer your patients’ and your own questions about ACA, how to enroll for the required health insurance coverage and possible financial assistance. You can also direct individuals to HealthCare.gov (Spanish: CuidadoDeSalud.gov) for state-specific information or recommend they call 1-800-318-2596 (TTY: 1-855-889-4325) to ask questions and sign up for coverage.
October is Sudden Cardiac Arrest Awareness Month
October is Sudden Cardiac Arrest (SCA) Awareness Month, an initiative of the Heart Rhythm Society (HRS), Washington, D.C., to highlight SCA as a serious problem distinct from myocardial infarction (MI). Those who survive MI have the highest risk of SCA, which claims one life every two minutes, taking more lives each year than breast cancer, lung cancer or AIDS, according to the HRS. Download the free SCA Resource Kit.
Celebrate Emergency Nurses Week
Oct. 6-12 is Emergency Nurses Week (Oct. 9 is Emergency Nurses Day), a national celebration with the theme “Everyday Extraordinary,” sponsored by the Emergency Nurses Association, Des Plaines, Ill. Download the poster and participate in the Instagram contest.
Universal ICU Decolonization: An Enhanced Protocol
The REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs. Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus) found that “universal decolonization was the most effective intervention to reduce MRSA infections.” This enhanced protocol includes instructions to implement universal decolonization in adult ICUs.
On Sept. 23, the U.S. Food and Drug Administration (FDA), Silver Spring, Md., announced that it is requiring color changes in the writing on Duragesic (fentanyl) pain patches, manufactured by Janssen Pharmaceuticals, Raritan, N.J. The change is intended to make it easier for patients and caregivers to find patches on patients and to see patches that have fallen off, which children or pets could accidentally touch or ingest. The FDA is asking manufacturers of generic fentanyl patches to make a similar change.
On Sept. 20, the FDA announced that Baxter International, Deerfield, Ill., recalled two lots of Dual Luer Lock Caps because of loose particulate matter in the packaging.
CDC publishes flu vaccine recommendations
On Sept. 20, the Centers for Disease Control and Prevention (CDC), Atlanta, published “Prevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2013-2014,” in Morbidity and Mortality Weekly Report.
The Joint Commission releases sentinel event data
On Sept. 20, The Joint Commission, Oakbrook Terrace, Ill., released “Sentinel Event Data – General Information: 1995-June 2013,” which notes that reporting most sentinel events is “voluntary and represents only a small proportion of actual events.”
Resources from the AHRQ
Visit the website of the National Guideline Clearinghouse, Agency for Healthcare Research and Quality (AHRQ), Rockville, Md., for a summary of “Physical Restraints and Side Rails in Acute and Critical Care Settings,” published in “Evidence-based Geriatric Nursing Protocols for Best Practice, 4th ed.”
Access the patient safety primer “Teamwork Training,” which explains the principles behind teamwork training and identifies programs designed for healthcare settings.
Nursing care hours data
Data on nursing care hours from the National Database of Nursing Quality Indicators are “substantially reliable for use in national comparable benchmarking reports for hospitals’ quality improvement activities and research,” concludes “A Standardized Measure: NDNQI Nursing Care Hours Indicator,” posted online Sept. 2 in WJNR: Western Journal of Nursing Research.
AACN live webinar addresses shivering in hypothermia
Does the troublesome — and dangerous — adverse effect of shivering complicate your targeted temperature management efforts? Join critical care educator Mary Kay Bader Thursday, Nov. 14, 10 a.m. PT, for her live presentation, “All Shook-up: Managing Shivering in Therapeutic Hypothermia.” This free webinar will review the pathophysiology of shivering, reliable assessment tools and suggested interventions to counter shivering. Registration includes the live event, implementation tools and resources, online discussion forum and access to the on-demand recording. Learn more and register.
From October's AACN Bold Voices
"It’s the ‘I’ Word" — Vicki Good, AACN President 2013-2014
NTI 2014 Step Forward Note Cards Set of 10
Sending a note or thank you card is the perfect way to express yourself anytime. Let your friends and colleagues know you care whether you're marking a special occasion, saying thanks or just keeping in touch. A personal note on a beautiful card will make a lasting impression.
Member Price: $5.00 (Non-Member: $7.00)
EKGs for the Nurse Practitioner and Physician Assistant
Author: M. Knechtel
(Book, 265 pages, 2013)
It is vital for NPs and PAs to be highly skilled in EKG interpretation to correctly identify high-risk patients and to make appropriate clinical decisions. This reference book is the first to present a comprehensive, multifaceted approach to EKG interpretation, covering all major topics required for expertise in this area.
Member Price: $45.00 (Non-Member: $50.00)
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The Certification Practice Specialist participates in the development, review and validation of acute and critical care nursing content for AACN's certification products.
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Clinical Practice Specialist – American Association of Critical-Care Nurses
The Clinical Practice Specialist leads the development, review and validation of acute and critical care nursing content for designated AACN learning products and services.
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