Bold Voices - January 2011 - (Page 16)

AT THE BEDSIDE Nurse Manager Nursing Excellence, Award Winning Healthcare Recognized for service excellence under the J.D. Power & Associates Distinguished Hospital Program, Bayhealth Medical Center, a community minded health care organization with locations serving all 3 DE counties, offers a competitive salary, flexible benefits & tuition reimbursement. We are seeking a dynamic Critical Care Nurse Leader to manage two units (ICU/IMC) at our Milford campus. Requirements: • BSN; MSN preferred. • Must be certified in critical care or nursing leadership. • Previous leadership role and five years within the specialty is required. • Delaware RN License/or compact state. Basic Microsoft technology and data management. Strong communication skills and customer service are essential. Shared governance model, and a demonstrated commitment to nursing excellence is needed. To apply online, visit In Our Journals Hot topics from this month’s AACN journal Delirium, often undetected, may indicate underdiagnosed physiological abnormalities such as sepsis, myocardial infarction or metabolic issues. Using the Confusion Assessment Method to identify prevalence and predictors of postoperative delirium, a study found that at least one episode of delirium occurred in one in three patients. The patients wereolder, unmarried, had impaired mobility and an ICU admission. The cardinal features of delirium are acute onset with fluctuation, inattention, disorganized thinking and altered level of consciousness. Nurses are often the first to notice changes and can talk with family, who are familiar with a patient’s usual mental functioning. Timely recognition and consultation with psychogeriatric care clinicians is associated with improved patient outcomes. (Mangnall et al, AJCC, Jan 2011) What happens after chronically critically ill patients leave ICU? An increasing body of evidence suggests that neither patients nor their caregivers live happily ever after. Researchers found that 64 percent of patients had not returned to their preadmission functional level by six months after discharge from the ICU. This affected caregivers who reported substantial lifestyle restrictions, particularly in social life and recreation, and distress as a result of patients’ physical and psychological problem behaviors. Interventions that improve patients’ functional status may yield greater independence for patients and caregivers. (Choi et al, AJCC, Jan 2011) Do beta blockers decrease the effects of anxiety in heart attack patients? These medications should limit the stimulating effects of anxiety on the sympathetic nervous system and are recommended for all patients with acute myocardial infarction. Researchers compared the number of in-hospital complications and length of stay after acute myocardial infarction. Compared with nonanxious patients, anxious patients had a significantly longer length of stay and higher rate of complications such as ischemia, ventricular tachycardia, ventricular fi brillation, reinfarction and cardiac death. The use of beta blockers did not differ in either group and did not appear to eliminate the effects of anxiety. Of note, most patients did not receive the recommended dose of beta blockers. (Abu Ruz et al, AJCC, Jan 2011) 16 JANUARY 2011

Table of Contents for the Digital Edition of Bold Voices - January 2011

Front/Digital Edition Viewing Guide
Another Angle
AACN Boards and Contact Information
New HHS-CCSC Awards Recognize HAI Reductions
Zero Tolerance for Preventable Incidents Involves Non-Surgical Specialties
Bold Voice: Chatting with MaryAnn Stump
Facebook Asthma?
EOL Care Rises for Heart Failure Patients on Medicare
More Patient, Family Contact Needed in EOL Care
Chronic Lung Disease of Prematurity Increases Respiratory Risk in Day Care
Childhood Obesity Linked to Viral Infections
Pharmaceutical Safety at Home
DTaP, Tdap: What's in a Name?
In Our Journals
STOP-BANG Helps Identify Surgical Patients at Risk
Fewer Blood Transfusions Can Improve Patient Safety, Reduce Costs
Certification Capsules
Dues, NTI and Certification Fees Will Not Increase
From the President

Bold Voices - January 2011