Bold Voices - August 2012 - (Page 18)

AT THE BEDSIDE In Our Journals Hot topics from this month’s AACN journal Delirium in critically ill older adults is associated with suboptimal outcomes — including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization and new onset of cognitive impairment. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complex, because patients may be voiceless, extremely ill and require high sedation levels to facilitate mechanical ventilation. An aggressive, appropriate and compassionate strategy to manage delirium may reduce suffering and adverse outcomes and improve relationships among nurses, patients and families. (Balas et al, CCN, Aug 2012) Medical device-related errors are often misunderstood. Whether an error is manufacturer-related or involves device use, the sheer number and complexity of devices and their expanded use in new environments increases risk. Risk may be reduced by careful and deliberate evaluation of devices, along with application of human factors engineering principles during device development and implementation. Nurses can uniquely contribute to proactive evaluation of device-related risk facebook.com/ccnface and deeper understanding of devicerelated events and near misses. (Mattox, CCN, Aug 2012) Through active learning, rich anecdotal narratives are theorized to support the acquisition of cognitive, social, cultural and emotional knowledge, and motor skills. Case history narratives support studentcentered learning and development of clinical reasoning. To fi ll the information gap about their use in the education of acute and critical care advanced practice nursing students (APRNs), Winkelman and colleagues explore the value of case histories in APRN education and evaluation in distance and face-to-face learning. (Winkelman et al, CCN, Aug 2012) www.ccnonline.org twitter.com/ccnme BBQ Grill Brush Wires Pose Ingestion Hazard A summer barbecue can lead to an emergency department visit if someone accidentally ingests metal wire bristles that become stuck in grilled meat, notes “Inadvertent Ingestion of Wire Bristles From a Grill Cleaning Brush: Radiologic Detection of Unsuspected Foreign Bodies” in American Journal of Roentgenology. Emergency physicians at Rhode Island Hospital, Providence, treated six cases of ingested metallic wire from grill-cleaning brushes in an 18-month span, according to a related EmaxHealth article, “Grilled Meat Danger Surgery.” Wiping a barbecue grill with in Rhode Island Requires Life-Saving abdominalEach patient who grills complained of painful swallowing or pain had cleaned with wire brushes just before cooking and was admitted within 24 hours a wet towel can remove of eating. hazardous wire bristles. The abdominal pain led to major surgery in three cases, with two perforations of the small intestine and one of the stomach and into the liver. Radiologic or computed topography showed bristles lodged in the neck of three patients, and they were removed with endoscopic techniques, the article reports. Wiping a grill with a wet paper towel can remove the potentially hazardous wire bristles, the article says. “The public should be aware of this potential danger,” David Grand, the hospital’s radiologist, tells EmaxHealth. The study acknowledges lack of information on how widespread this issue might be and thus seeks to raise awareness and encourage further research. 18 www.aacnboldvoicesonline.org AUGUST 2012 http://www.ccnonline.org http://www.ccnonline.org http://www.ccnonline.org http://www.ccnonline.org http://www.ccnonline.org http://www.ccnonline.org http://www.ccnonline.org http://www.facebook.com/ccnface http://www.ccnonline.org http://www.facebook.com/ccnface http://www.twitter.com/ccnme http://www.aacnboldvoicesonline.org

Table of Contents for the Digital Edition of Bold Voices - August 2012

Front/Digital Edition Viewing Guide
Another Angle
‘AACN CSI Academy’ National Leadership Program Launches
Canadian Dynamics 2012: ‘Speak Up, Speak Out’
Grana Padano May Lower Blood Pressure
New Medicare Patient Satisfaction Requirement Misses Mark, Nurse Argues
FDA, The Joint Commission Aim to Reduce Alarm Fatigue
Fast Food in Hospitals Counters Goal of Healthy Eating
New Federal Hospital Visitation Standards
Nurse Obesity Linked to Long Hours
First-Ever Nurses Float Joins the 2013 Tournament of Roses Parade
AMA Urges Greater Focus on Ambulatory Patient Safety
Minimally Invasive Heart Valve Procedure Increases Patient Survival
Older Patients' in ICU at High Risk for HAI
Tele-ICU Symposium Explores Leading-Edge Technology
In Our Journals
Certification Capsules
Dare To
Contribute to the Evidence: Apply for an AACN Research Grant by Nov. 1
From the President
Back

Bold Voices - August 2012

http://www.nxtbook.com/nxtbooks/aacn/boldvoices_202002
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_202001
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201912
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201911
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201910
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201909
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201908
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201907
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201906
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201905
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201904
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201903
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201902
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201901
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201812
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201811
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201810
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201809
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201808
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201807
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201806
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201805
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201804
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201803
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201802
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201801
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201712
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201711
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201710
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201709
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201708
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201707
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201706
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201705
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201704
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201703
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201702
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201701
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201612
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201611
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201610
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201609
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201608
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201607
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201606
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201605
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201604
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201603
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201602
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201601
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201512
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201511
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201510
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201509
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201508
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201507
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201506
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201505
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201504
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201503
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201502
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201501
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201412
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201411
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201410
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201409
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201408
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201407
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201406
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201405
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201404
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201403
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201402
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201401
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201312
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201311
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201310
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201309
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201308
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201307
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201306
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201305
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201304
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201303
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201302
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201301
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201212
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201211
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201210
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201209
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201208
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201207
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201206
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201205
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201204
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201203
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201202
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201201
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201112
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201111
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201110
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201109
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201108
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201107
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201106
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201105
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201104
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201103
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201102
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201101
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201012
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201011
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201010
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201009
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201008
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201007
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201006
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201005
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201004
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201003
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201002
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201001
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200912
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200911
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200910
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200909
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200908
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200907
http://www.nxtbookMEDIA.com