Bold Voices - March 2013 - (Page 28)

AT THE BEDSIDE In Our Journals Hot topics from this month’s AACN journal How much care is too much? Moral distress and burnout are important negative repercussions when healthcare professionals provide care they perceive to be inappropriate. Yet very little research focuses on how feelings of providing inappropriate care contribute to high-quality clinicians leaving their job. This month’s editorial uses the APPROPRICUS trial — a one-day cross-sectional study of 2,000 clinicians in European and Israeli ICUs that found 27 percent felt they were providing inappropriate care — as a springboard to examine the challenges of inappropriate care. (Savel et al, AJCC, Mar 2013) Can psychological empowerment lessen moral distress for critical care nurses caring for patients at end-of-life (EOL)? Moral distress results from internal 28 MARCH 2013 conflict related to ethical dilemmas that interfere with a course of action the clinician believes to be right. A survey of the relationship between moral distress and empowerment found: (1) Nurses who participate in EOL patient-care conferences, with increased collaboration leading to empowerment, had less moral distress. (2) Nurses with more years of experience and those who received EOL training had a higher intensity of moral distress intensity when faced with patient care they considered futile. (3) Nurses with a higher level of perceived empowerment experienced moral distress less often. (Browning, AJCC, Mar 2013) A criteria-based reminder for catheter removal was tested among caregivers of patients with urinary catheters. Use of a tool that prompts providers to remove urinary catheters or provide a rationale based on established criteria for catheter retention significantly reduces urinary catheter use and incidence of catheter-associated urinary tract infections (CAUTIs). Presence of a urinary catheter and the duration of bladder catheterization are significant risk factors for urinary tract infections. Earlier urinary catheter removal doesn’t increase the likelihood of catheter replacement. Applying evidence-based strategies to guide insertion, maintenance and timely catheter removal can reduce CAUTIs. Nurses can be instrumental in preventing UTIs by driving evidence-based care of patients with a urinary catheter. (Chen et al, AJCC, Mar 2013)

Table of Contents for the Digital Edition of Bold Voices - March 2013

Front/Digital Edition Viewing Guide
Another Angle
Design an NTI Just for You
New Guidelines Set Practice Framework for Tele-ICU NursingPractice
New Methods Increase Speed of Sepsis Diagnosis
High Blood Pressure Can Injure the Brain of Young Adults
Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants
Superstorm Sandy Hospital Evacuation Decisions Questioned
New STEMI Guidelines Focus on Symptom Recognition, Ease of Use
Early Communication About Resuscitation Improves EOL Quality
Vote Now for AACN Board, Nominating Committee Members
Simple Measures Reduce Pneumonia
Fresh Blood in the ICU
Meeting Veterans’ Healthcare Needs
In Our Journals
Checklists May Reduce Venous Thromboembolism
Certification Capsules
Chapter Leadership Workshop @NTI 2013
Wear Your NTI Pride on May 20
Dare To

Bold Voices - March 2013