Bold Voices - August 2013 - (Page 20)

AACN New CCN Resource Expands Reader Access to Nursing Care Studies C ritical Care Nurse (CCN), AACN’s bimonthly clinical practice journal for high Cochrane Review Summary acuity, progressive and critical care nurses, adds a new department this N-Acetylcysteine for Sepsis and Systemic month to provide readers with ongoing access to nursing care research. Inflammatory Response in Adults Every April, August and December, the journal will publish summaries of Cochrane Collaboration research reviews relevant to critical care nursing in the new Cochrane Review Summary. The summaries translate valid and reliable research into implications Critical Care Nurse partners with the for critical care nursing practice. Cochrane Collaboration to publish The topic of summaries of research reviews this month’s Plasmapheresis Cochrane Review Supportive Therapy for a relevant to critical care practice. Patient Undergoing Plasmapheresis Summary is the Craniosynostosis effectiveness of intravenous N-acetylcysteine for treating Parents’ Stress in the NICU critically ill patients with systemic inflammatory response syndrome or sepsis in the ICU. The Cochrane Collaboration, an international, indepenCritical Care Nurses Serving dent, nonprofit organization of more than 28,000 people from on Hospital Ships 100 countries, produces, updates and disseminates systematic reviews of research on the effectiveness of healthcare therapies to support informed healthcare decisions based on the latest accumulated scientific evidence. Cochrane Reviews are published in The Cochrane Library, an online collection of databases. “Although critical care nurses can access the hundreds of Cochrane Reviews and updates completed each year, few relate directly to critical care, acute care or progressive care patient populations,” says CCN Editor Grif Alspach. “However, the Cochrane Nursing Care Field — an entity within the Cochrane Collaboration — prepares summaries of nursing care-relevant Cochrane Reviews for publication in nursing journals. We are very pleased to work with Cochrane to bring these summaries to our readers, who have asked for more research-related content.” A summary of findings from the Cochrane Library with implications for critical care nursing Vicky Visvanathan, RN, CCRN, GradDipCriticalCareNursing, MN Review Question How effective is intravenous N-acetylcysteine for treating critically ill patients with systemic inflammatory response syndrome (SIRS) or sepsis in the intensive care unit (ICU)? Relevance to Critical Care Nursing A U G U S T 2 0 1 3 • V O L U M E 3 3 SIRS is a clinical condition that commonly occurs in patients as a result of major trauma, sy systemic infection, or major surgery.1 SIRS causes massive inflammatory dysfunction involving activation of leukoinflammat N U M B cytesR endothelial cells and the release of inflammatory mediators E and 4 and toxic oxygen free radicals of intracellular and extracellular origin.1 radi This mechanism leads to abnormalities in tissue perfusion and tissue hypoxia that result in tissue destruction, multiorgan failure, and death tissu of critically ill patients in the ICU. Intravenous N-acetylcysteine has been used as an antioxidant N N-acetylcy damag defense to prevent damage due to oxygen free radicals in patients with septic shock.1 A systematic review was therefore warranted to determine intravenous N-acetylcysteine to treat critically ill the effects of using intrave patients g seps T h e j o u r n a l f o r h i g h a c u i t y , p r o g r e s s i v e , a n d c r i t i c a l c a r e n u r s i nwith SIRS or sepsis in the ICU. CriticalCareNurse CNE Contributing Editor r Daphne Stannard, the contributing editor for the Cochrane Review Summary, is the contrib Chief Nurse Researcher and Director of the Institute for Nursing Excellence at UCSF D Medical Center, San Francisco California. She is also the Director of the UCSF JBI Francisco, Centre. For questions related to this ar article, contact Daphne Stannard at daphne.stannard ©2013 American Association of Critical-Care Nurses doi: Cri 76 CriticalCareNurse CNE Vol 33, No. 4 AUGUST 2013 4, Study Description and Interventions This is the summary of a Cochrane systematic review. Only randomized controlled trials (RCTs) were eligible for inclusion in the review; cross-over or quasi-randomization designs were excluded. Participants were patients with SIRS or sepsis, irrespective of their underlying illness. SIRS and sepsis were assessed according to the criteria established by Bone et al.1 Interventions were as follows: N-acetylcysteine in bolus intravenous doses or as a continuous infusion or a combination of both. The review also included studies wherein intravenous N-acetylcysteine was compared with placebo or was used as a standard treatment. The dose of N-acetylcysteine varied from 25 mg/kg to 150 mg/kg across studies, and the timing and duration of N-acetylcysteine treatment varied from a single bolus dose to infusion up to 7 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes included length of stay in the ICU, duration of mechanical ventilation, duration of inotropic CNE 20 Contribute to the Evidence: Apply for an AACN Research Grant by Nov. 1 Findings from AACNfunded studies help bedside clinicians ensure safe and excellent care. AACN enthusiastically supports our community’s members to seek evidence that assists bedside colleagues in ensuring safe and excellent care for patients and their families. Research grant applications open Sept. 1 and must be submitted online by Nov. 1. Grants from AACN fund research that drives change in high acuity and critical care nursing practice. For example, recent grants funded studies on the potential for standardizing ventilator withdrawal for patients at the end of life and assessing the predictive validity of the Braden Q Scale in the development of immobility-related pressure ulcers among children. AACN will award up to three $50,000 Impact Research Grants to fund priority projects that address gaps in clinical research at the organization or system level and translate findings to bedside clinicians. Other grants include the AACN-Sigma Theta Tau Critical Care Grant and three AACN-Philips Medical Systems Clinical Outcomes Grants, up to $10,000 each. Studies are expected to be completed in two years. Initiatives may include technology to achieve optimal patient assessment, management and/or outcomes; healing and humane environments; processes and systems for the optimal contribution of high acuity and critical care nurses; symptom management; and managing outcomes and preventing complications. Each principal investigator must be a current AACN member and submit his or her own application. For detailed information, criteria and supporting documents, visit www. or email research@ Are you a researcher or past AACN grant awardee? Consider serving on the review panel to select the next grantees. Write to and include your curriculum vitae.

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