Bold Voices - June 2014 - (Page 16)

AT THE BEDSIDE In Our Journals Hot topics from this month's AACN journal Rapid response teams intervene in the care of hospitalized patients who experience serious adverse events, including cardiac arrest and unexpected admission to the intensive care unit. The teams bring clinical experts quickly to the patient's bedside. A cost-neutral structure for a rapid response team led by an ICU nurse was implemented. Six years later, results show that a sustainable and effective response team can be put into practice without increasing costs or adding positions. It also can decrease the percentage of cardiopulmonary arrests occurring outside the ICU. (Mitchell et al, CCN, Jun 2014) Critical care nurses play a key role in the safe administration of cardiac diagnostic testing by educating patients about the test and explaining the results. Therefore, nurses should be knowledgeable about the most common noninvasive testing procedures used to diagnose coronary heart disease - transthoracic echocardiography, stress testing, multidetector computed tomography, coronary artery calcium scoring and cardiac magnetic resonance imaging. The article reviews how each test is administered, what information is provided by the results and what nurses need to know when caring for patients who have the tests. (Ramos, CCN, Jun 2014) 16 Test Can Predict Breast Cancer Outcomes Use of biomarkers gives clinicians a formula to determine which treatments may work, based on how large and how advanced the cancer is. A Information on the use of neuromonitoring in ICUs is scattered but significant. Nurses who do not care for neurologically impaired patients on a daily basis may not have a strong understanding of the utility of various neuromonitoring techniques, why they are used or how they are interpreted. Transcranial Doppler sonography and electrophysiology are two types of neuromonitoring that are frequently seen but poorly understood. Because information about them tends to be either very technical or superficial with limited critical care applicability, this review provides information about neuromonitoring to guide critical care nurses caring for patients who are neurologically impaired. (Harris, CCN, Jun 2014) prognostic test for women with breast cancer can predict outcomes, notes a study posted online in BJC: British Journal of Cancer. "Nottingham Prognostic Index Plus (NPI+): A Modern Clinical Decision Making Tool in Breast Cancer" states that NPI+ will provide a more sophisticated personalized treatment tool for patients with breast cancer by providing better prognostic analysis, prediction of disease recurrence and economic savings. This development is an update from the original NPI, adds a related article on The new NPI+ "includes even more biomarkers of the disease and could be available to patients within two years." The study used more than 1,000 breast cancer samples to apply a comprehensive panel of biomarkers with relevance to breast cancer to "a large and well-characterized series of BC (breast cancer), using IHC (immunohistochemistry) and different multivariate clustering techniques, to identify the key molecular classes," the article adds. Jackie Harris, clinical nurse specialist at Breast Cancer Care, explains in the article that "breast cancer is the most commonly diagnosed cancer in women in the UK and making decisions around benefits of certain treatments can often be difficult and stressful for patients." This procedure will give clinicians a formula to determine which treatments may work, based on the size of the cancer and how advanced it is, the article notes. Harris adds, "The Nottingham Prognostic Index Plus test will highlight an individual's risk and could be a useful tool to help patients to make these treatment decisions."

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

Another Angle
Pres Note Teaser
‘Take a Chance to Make a Change in Your Patients’ Lives’
New Mobile App Launched: AACN Bedside
AACN Research Grants Continue to Drive Evidence-Based Care
AACN Scholarships to Develop Training Skills and Professional Growth
Institutional Racism Can Damage Healthcare
Culture of Violence Becoming Normal
Nip Ethical Violations in the Bud
Up to Half of Prescribed Antibiotics Unnecessary, Inappropriate
Minimal Sedation, Early Mobilization May Reduce Delirium
Care Transition Programs Reduce Readmissions, Penalties
Unclear Relationship Between Hypothyroidism and Mild Cognitive Impairment
Women Have Unique Stroke Risks
Costs Increase Because of More Inpatient Constipation
Nursing-Supportive Work Environments Linked to Better Care
Smile, You’re on ReadyCam!
Automated EHR-Linked Checklist Greatly Reduces CLABSIs
Online Game Helps Students Identify, Manage Sepsis
Sepsis Detection System More Effective in Patient Diagnosis
In Our Journals
Test Can Predict Breast Cancer Outcomes
Spice It Up With Cinnamon
IHEs: Significant Cause of Preventable ED Visits
Certification Capsules
With Deep Appreciation for Your Generosity
Save the Dates for Progressive Care, Nurse Manager Fall Conferences
AACN Chapters Model Excellence
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - June 2014