Bold Voices - August 2013 - (Page 18)

AT THE BEDSIDE In Our Journals Hot topics from this month’s AACN journal How does a nurse practice critical care in a large hospital at sea? Critical care nurses serving aboard two U.S. Navy hospital ships — USNS Comfort and USNS Mercy — provided free humanitarian clinical services to developing nations in Central and South America and Southeast Asia. Host nation patients came aboard for prearranged surgery then returned to land for follow-up care from local clinicians. Nurses went onshore to assist in clinics, teach as experts or participate in construction projects. Environmental conditions influenced the availability and services of the ships, which could also be deployed to provide support for disaster relief. (Faulk and Hanly, CCN, Aug 2013) Plasmapheresis is safe, rapid and effective for emergent management of severe hypertriglyceridemia in critically ill patients. A case report describes a woman with diabetic ketoacidosis and severe hypertriglyceridemia treated with plasmapheresis when conventional treatments did not help. She was admitted to a medical ICU because of diabetic ketoacidosis with severe lipemia. Serum triglyceride levels decreased by 77 percent in less than 24 hours after plasmapheresis after other treatments had limited effect. The impact of plasmapheresis on critical care nurses is growing as they become involved in treatment and follow-up care. (Seda et al, CCN, Aug 2013) A U G U S T 2 0 1 3 • Optimal treatment for toxic epidermal necrolysis (TEN) generates considerable debate. Over the years, plasmapheresis has gained support as a treatment. Supportive therapy and expert wound care are especially needed — for example, experienced ICU nursing teams provide daily care of tissues affected in Plasmapheresis the most severe cases of Supportive Therapy for a Patient Undergoing TEN — when alternaPlasmapheresis tive treatments, such as Craniosynostosis plasmapheresis, are used. Parents’ Stress in the NICU A case study describes a patient with severe TEN who underwent two cycles of therapeutic Critical Care Nurses Serving on Hospital Ships plasma exchange. He also received specialized wound care for widespread skin damage on more than 80 percent of his body surface area. (Seczynska et al, CCN, Aug 2013) V O L U M E 3 3 N U M B E R 4 CriticalCareNurse T h e j o u r n a l f o r h i g h a c u i t y, p ro g re s s i v e , a n d c r i t i c a l c a re n u r s i n g CNE CNE CNE 18 Antibiotics May Relieve Back Pain in Certain Cases Antibiotics should only be prescribed to treat back pain associated with an identified bacterial cause. P atients with chronic low back pain and vertebral bone edema may benefit from antibiotic therapy, notes a study in European Spinal Journal. “Antibiotic Treatment in Patients With Chronic Low Back Pain and Vertebral Bone Edema (Modic Type 1 Changes): A Double-Blind Randomized Clinical Controlled Trial of Efficacy” states that the antibiotic arm of the study improved significantly on all outcome measures. The patients in the study received a 100-day course of antibiotic treatment (Bioclavid, a European drug combining amoxicillin and clavulanate) or placebo and were “blindly evaluated at baseline, end of treatment and at 1-year follow-up.” The primary outcome measure was diseasespecific disability and lumbar pain, and secondary outcomes included leg pain, number of hours in pain for the previous four weeks and global perceived health. Nearly half — 46 percent — of patients in the study had a bacterial infection, says a related article in The Daily Briefing that cautions practitioners about using antibiotics without verified infections. “Antibiotics should only be prescribed to treat back pain once a bacterial cause has been identified.”

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

Bold Voices - August 2013
Another Angle
Seamless Staff Leadership Transition Is Goal of AACN's CEO Search
A Pool of Exceptional Talent
Progressive Care Nurses: A Conference, Las Vegas and CNEs Just for You
Communication Is Critical to Avoid Readmissions
Hospital Deaths Decrease Slightly Over 10 Years
Leapfrog Rates Hospital Safety Performance
Patient Safety Threatened by Insufficient Nurse Staffing, Fatigue
Number of Americans With Dementia, Cost of Care to Double by 2040
Updated HHS Standards Support Improved Cultural and Linguistic Competency
Decrease Noise Levels to Improve Patient Outcomes
Alarm Management (AACN Practice Alert)
Survey Reports High Levels of Burnout, Job Seeking
New HIPAA Rule Seeks to Balance Patients' Privacy Protection
Pet Ownership May Be Heart-Friendly
Hospitals Better at Preventing CLABSIs
Online Program Helps Military Service Members, Veterans Become Nurses
Clot Busters Safe for Patients With Stroke Who Take Aspirin
Updated Stroke Definition Reflects New Knowledge, Advances
In Our Journals
Antibiotics May Relieve Back Pain in Certain Cases
Certification Capsules
AACN Members, Friends Inducted as AANP Fellows
Empowered ED Case Managers
New CCN Resource Expands Reader Access to Nursing Care Studies
Contribute to the Evidence: Apply for an AACN Research Grant by Nov. 1
Nurse Leaders, Aspiring Nurse Leaders: Get Ready for Las Vegas, Sept. 18-20
AACN Scholarships Support Your Learning Journey
What Is Your Wake? (From the President)

Bold Voices - August 2013