Bold Voices - June 2018 - 17

AT THE BEDSIDE

W

Is cardiovascular
fitness in middle age
associated with a
decrease in dementia
risk for women?

omen in Sweden with high fitness levels were 88 percent less likely to
develop dementia compared to those with moderate fitness.
"Midlife Cardiovascular Fitness and Dementia: A 44-Year Longitudinal Population
Study in Women," in Neurology, reveals that highly fit women in the study developed
dementia later than women who were moderately fit. If they did develop dementia, the high fitness group did so at age
90, on average 11 years later than moderately fit women.
A sample of 1,462 women in Sweden, ages 38 to 60, was examined in 1968. Of those, a subsample of 191, average age 50, took an
ergometer cycling test to measure cardiovascular capacity. After
one fitness test, approximately 40 in the subsample were categorized as highly fit, 92 were medium fit and 59 were in the low-fit
category.
"Over the next 44 years, the women were tested for dementia six times," adds a related article in ScienceDaily. Only
5 percent of the high fitness group developed dementia versus 25 percent of moderately fit women and 32 percent of
those with low fitness. Dementia was determined according to DSM-III-R criteria.
The encouraging results show that "high cardiovascular fitness in midlife was associated with a decreased risk
of subsequent dementia," the study notes. "I was very surprised that high fitness was so protective. And that so few
developed dementia in the high fitness group," lead study author Helena Hörder, a physiotherapist at University of
Gothenburg, Sweden, says in a related article in Time. Findings are not causal, and more research is needed to determine when fitness benefits start to accrue and affect the risk of dementia. d

Possible Link Between
High Fitness and Reduced
Risk of Dementia

REFERENCE: Hörder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: a 44-year longitudinal population study in women [published online March 14, 2018].
Neurology. doi:10.1212/WNL.0000000000005290.

'Timeout' Reduces
Medication Errors

A

brief review at the end of a facility's morning rounds
led to a significant number of medication changes for
ICU patients.

determine if any medications were erroneous or missing), so
the study notes the changes likely occurred only because of the
intervention.
Team communication also improved with the timeouts, which
provided opportunities for education, as 18.4 percent of cases
prompted additional discussions that did not lead to any medication changes.

The study's "design does not establish causality between
"The Impact of a Daily 'Medication Time Out' in the Intensive
patient outcomes and the intervention." In addition, the effect
Care Unit," a small-scale study in Journal of Critical Care,
size of the intervention may be overestimated. "Team members
notes that the interventions, lasting an average of 1.24
realized that changes were being
minutes each, led to 285 medication changes in
This low-cost qualityrecorded, which may have encouraged
347 patient encounters in a 12-bed cardiac-surimprovement intervention more changes than would have occurred
gical ICU. Changes were graded as trivial (40.4
otherwise."
percent), minor (50.5 percent) or major (9.1
identifies medication
percent).
The study was conducted in a "specific
errors and may improve
surgical population with a high rate of
The daily timeout may help avoid medication
patient safety.
patient turnover and multiple providers
errors, and "eliminating superfluous medicaparticipating in patient care. It is possible that the rate of medition orders may further decrease the potential for adverse
cation changes would be different for patients with a longer ICU
medication effects and interactions and streamline care
length of stay, or with smaller provider teams." d
by eliminating the 'noise' of unnecessary orders." The
timeout involved a recitation of the medication list from
REFERENCE: Tainter CR, Nguyen AP, Pollock KA, et al. The impact of a daily "medication time
out" in the intensive care unit. J Crit Care. 2018;43:366-369.
the electronic health record at the conclusion of rounds (to

www.aacnboldvoicesonline.org 17


http://n.neurology.org/content/early/2018/03/14/WNL.0000000000005290 http://n.neurology.org/content/early/2018/03/14/WNL.0000000000005290 https://www.sciencedaily.com/releases/2018/03/180315101805.htm http://www.jccjournal.org/article/S0883-9441(17)30710-4/fulltext http://www.jccjournal.org/article/S0883-9441(17)30710-4/fulltext http://www.aacnboldvoicesonline.org

Table of Contents for the Digital Edition of Bold Voices - June 2018

Urine
The Power of Possibility
Sepsis: What Nurses Can Do
New Sepsis Bundle From Surviving Sepsis Campaign
Understanding CERPs for Specialty Certification Renewal
In Our Journals
Transitions
America’s ‘Other’ Drug Problem Needs Attention
Effect of Haloperidol on Reducing Mortality
Transitional Care Nurses Can Reduce Admissions of Older Patients
ASHP Developing Standardized Medication Concentrations
Online AACN Course on Care of Older Adults
Hospital Programs Help Employees Cope With Traumatic Events
National Summit on Identification, Prevention and Management of Burnout
Barbershops Help Black Patrons Control Hypertension
Nurse Treats Himself for Myocardial Infarction Using Telehealth
We Have Consensus: TeleICU Continues to Evolve
Cooking Classes Help Patients With CHF
Beware of Chicken Nuggets — and Other Ultra-Processed Foods
Apple Watch Might Randomly Reboot in ICUs
Wound-Monitoring App Helps Reduce Hospital Readmissions
All Antidepressants Beat Placebo for Acute Major Depressive Disorder
Patients’ Online Search Trends
‘Timeout’ Reduces Medication Errors
Possible Link Between High Fitness and Reduced Risk of Dementia
DAISY Award Honors Nurses Who Exemplify Exceptional Compassion and Skill
Interviews With Two Acute Care Nurse Practitioners
Hiring for Cultural Fit
AACN Unveils Updated Online Pharmacology Course
Appreciating the Little Things
Bold Voices - June 2018 - Cover1
Bold Voices - June 2018 - Cover2
Bold Voices - June 2018 - Urine
Bold Voices - June 2018 - The Power of Possibility
Bold Voices - June 2018 - New Sepsis Bundle From Surviving Sepsis Campaign
Bold Voices - June 2018 - Understanding CERPs for Specialty Certification Renewal
Bold Voices - June 2018 - Transitions
Bold Voices - June 2018 - Effect of Haloperidol on Reducing Mortality
Bold Voices - June 2018 - Online AACN Course on Care of Older Adults
Bold Voices - June 2018 - National Summit on Identification, Prevention and Management of Burnout
Bold Voices - June 2018 - Nurse Treats Himself for Myocardial Infarction Using Telehealth
Bold Voices - June 2018 - We Have Consensus: TeleICU Continues to Evolve
Bold Voices - June 2018 - 13
Bold Voices - June 2018 - Beware of Chicken Nuggets — and Other Ultra-Processed Foods
Bold Voices - June 2018 - Wound-Monitoring App Helps Reduce Hospital Readmissions
Bold Voices - June 2018 - Patients’ Online Search Trends
Bold Voices - June 2018 - Possible Link Between High Fitness and Reduced Risk of Dementia
Bold Voices - June 2018 - DAISY Award Honors Nurses Who Exemplify Exceptional Compassion and Skill
Bold Voices - June 2018 - 19
Bold Voices - June 2018 - Hiring for Cultural Fit
Bold Voices - June 2018 - AACN Unveils Updated Online Pharmacology Course
Bold Voices - June 2018 - Appreciating the Little Things
Bold Voices - June 2018 - Cover3
Bold Voices - June 2018 - Cover4
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