Bold Voices - April 2014 - (Page 14)

AT THE BEDSIDE In Our Journals Hot topics from this month's AACN journal Patients with heart failure who are depressed or anxious may be trapped in a harmful loop. The pathophysiological changes associated with heart failure might worsen comorbid depression and anxiety by altering neurohormonal function via activation of the hypothalamic-pituitaryadrenal axis, autonomic dysregulation and activation of cytokine cascades and platelets. Understanding these pathophysiological relationships is critical in order to implement appropriate treatments and educate patients and other health professionals. The Biopsychosocial Holistic Model of Cardiovascular Health can be used to describe the relationships among the underlying pathophysiology of heart failure, depression and anxiety. (Chapa et al, CCN, Apr 2014) Critical care nurses are vital to the translation of evidence-based practice as a practice norm, because they are part of the largest segment of the healthcare workforce. They must continually evaluate their practice to ensure application of the best evidence rather than practicing on the basis of tradition. Adapted from a presentation at the 2013 National Teaching Institute & Critical Care Exposition, four practice interventions within the realm of nursing - turning critically ill patients, sleep disruption in the ICU, feeding tube management in infants and children, and prevention of venothromboembolism - are critiqued on 14 the basis of current evidence. (Makic et al, CCN, Apr 2014) Used as elective, permanent destination therapy, a left ventricular assist device (LVAD) provides advanced heart failure patients with a longer life span. However, not all such patients benefit from implantation of an LVAD. Situations in which the device offers little or no improvement in quality of life are the reverse of destination therapy and are referred to as "destinations to nowhere." A case study illustrates the appropriate use of palliative care teams to address preparedness planning for patients with an LVAD and help decrease moral distress among bedside clinicians. (O'Neill et al, CCN, Apr 2014)

Table of Contents for the Digital Edition of Bold Voices - April 2014

Another Angle
President’s Note (Teaser)
NTI2014: You Have to Come! An Unmatched Experience in the Mile High City
AACN Clinical Priorities 2014: Clinical Topics for Bedside Clinicians
NTI Network: Connect Online to Plan Your Week
Step Forward! Vote in AACN’s Election 2014
You May Inherit Atherosclerosis From Your Mummy
Pain, Agitation, Delirium Guidelines Expand Nurses’ Toolkit
Pediatric Flu Deaths Still a Concern, Expanded Vaccinations Advised
Are Senior-Specific EDs Worth the Investment?
‘Stop Sepsis’ Program Reduces Mortality Rate 40 Percent
Better Relationships Between Nurses, Cleaning Staff Can Improve Patient Care
Patient Outcomes Improve With Surgeon-Led Mortality Reviews
Reducing Cross-Contamination from Healthcare Personnel Attire
New Biomarker Could Improve Outlook in Esophageal Cancer
Long-Term Survival of Kids After Out-of-Hospital Cardiac Arrest
Tight Glycemic Control Could Shorten Children’s Hospital Stay
Web-based Patient Portals Improve Self-Management
In Our Journals
Nurse-Patient Communication Enhanced in AACN CSI Academy Projects
Link Between Shingles and Stroke Risk?
In Utero Exposure to Dyslipidemia Heightens High LDL Risk in Offspring
Palliative Care: Conversations Matter
Improving Communication About Chronic Critical Illness
Certification Capsules
April 16: National Healthcare Decisions Day
New Editorial Consults, Other Publishing Events at NTI 2014
AACN Scholarships for August EBP, Research Methods Institutes
Early-Bird Registration Ends April 3
Attend the Chapter Leadership Development Workshop at NTI 2014
Vote Now!
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - April 2014