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September 3, 2015

Concise Critical Appraisal

The Effect of Universal Glove and Gown Use on Adverse Events in ICU Patients

Education

Register for Upcoming ICU Liberation Events
New Publication Offers Sedation Liberation and Patient Mobility Strategies

SCCM News

Participate in Twitter Chat Centered on Sepsis
Application Deadline for THRIVE Grant is September 8, 2015
SCCM Announces THRIVE Peer Support Collaborative Grant Awardees
AMA Releases Article on New ECMO/ECLS CPT Codes
The Effect of Universal Glove and Gown Use on Adverse Events in ICU Patients

Among the many attempts to decrease the rate of healthcare-associated infections is the implementation of specific contact precautions (gloves and gown for entry into rooms of patients colonized or infected with antibiotic-resistant bacteria) and universal precautions (gloves and gown for entry into every room) in the intensive care unit. However, the benefits of these precautions are unclear. Croft et al examined whether the use of universal precautions increased the rate of adverse events compared to usual care (gloving and gowning for only those patients on contact precautions).

They found that universal glove and gown use did not have an impact on the overall rate of adverse events, including subtypes of infectious, noninfectious, preventable, or severe adverse events.

Read the full Concise Critical Appraisal by logging in to the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

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Register for Upcoming ICU Liberation Events

The Society of Critical Care Medicine’s (SCCM’s) ICU Liberation Initiative aims to engage clinicians in improving practice and patient outcomes related to pain, agitation, delirium, and early mobility. Take advantage of two upcoming learning opportunities that will provide strategies to help reduce the risk of long-term consequences of an intensive care unit (ICU) stay. Registration is complimentary. Both events are held in collaboration with Project Dispatch, funded by the Agency for Healthcare Research and Quality, and the American Association of Critical-Care Nurses (AACN).

Webcast: Nurse-Driven Protocol for the Management of Alcohol and Polysubstance Abuse: AACN Clinical Scene Investigator Academy Project
September 16, 2015
1:00 p.m. – 2:00 p.m. Central Time
Register online today

In September 2013, the Maimonides Medical Center’s medical ICU implemented a nurse-driven protocol for the management of patients with severe alcohol and/or substance withdrawal. The project goals included alleviating nursing staff anxiety when caring for these patients, decreasing ICU lengths of stay, reducing the number of ventilator days, and decreasing falls.

In this session, Diane Byrum, RN, MSN, CCRN, CCNS, FCCM, Manager of Quality Implementation Programs at SCCM; Laurie Wilson, RN, MSN, Senior Staff I at Maimonides Medical Center; and Christina Ycaza-Gutierrez, RN, BSN, CCRN, Senior Staff II at Maimonides Medical Center, will explore the team’s journey throughout the execution of the project and review how project implementation goals were achieved. Faculty will also discuss other positive outcomes such as decreased overall hospital lengths of stay, decreased incidence of tracheostomies, the positive impact on the hospital’s financial budget, and the project’s continued ability to surpass expected goals six months after its completion.

Learning Objectives

  • Explore the development of the project algorithm, implementation of the protocol, challenges faced, and how these challenges were overcome
  • Describe positive project outcomes and sustainability six months after project completion

Webcast: Early Progressive Mobility in the ICU: AACN Clinical Scene Investigator Academy Project
September 29, 2015
1:00 p.m. – 2:00 p.m. Central Time
Register online today

Under the guidance of the AACN Clinical Scene Investigator (CSI) Academy, Duke Raleigh Hospital’s medical-surgical ICU implemented an early progressive mobility protocol. The goal was to decrease ICU lengths of stay and ventilator days while increasing mobility and positive patient outcomes through reduced incidence of hospital-acquired infections and complications. Since implementation, the unit has experienced a large number of successful outcomes and a strengthened ICU team and has created a collaborative interprofessional culture.

In this session, Cheryl L. Esbrook, OTR/L, BCPR, Program Coordinator for Occupational Therapy Professional Development at University of Chicago Medical Center; Katherine Geyer, BSN, RN, CCRN, CNIV, clinical lead to the Early Progressive Mobility in the ICU project at Duke University Health System/Duke Raleigh Hospital; and Kristin Merritt, MSN, MBA/HCM, RN, NE-BC, CCRN, Nurse Manager of Operations, Intensive Care Unit and Neuroscience Unit at Duke University Health System/Duke Raleigh Hospital, will discuss the team’s approach to implementation, project planning and protocol structure. They will also highlight challenges, qualitative and quantitative outcomes, and meaningful patient stories.

Learning Objectives

  • Identify goals and strategies for successful implementation of an early progressive mobility protocol for critically ill patients, including tests of change, staff education, interprofessional collaboration, and perceived barriers
  • Discuss initial and sustained outcomes and measurements resulting from the project
  • Describe how meaningful recognition and nurse leadership impact the success or failure of a project of this scale

If you have any questions regarding either event, please contact SCCM Customer Service at +1 847 827-6888.

These webcasts are held in collaboration with the AACN CSI Academy and Project Dispatch.

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New Publication Offers Sedation Liberation and Patient Mobility Strategies

Discover strategies for managing pain, agitation and delirium in intensive care unit (ICU) patients with ICU Liberation: The Power of Pain Control, Minimal Sedation, and Early Mobility, a publication from the Society of Critical Care Medicine (SCCM). Created by a team of intensive care experts, including Michele Balas, PhD, RN, APRN-NP, CCRN, FCCM; Terry Clemmer, MD, FCCM; and Ken Hargett, MHA, RRT, FAARC, FCCM, this must-have publication offers practical information to help frontline staff implement sedation liberation and promote ICU patient mobility.

Topics include:

  • Gap analysis in performance improvement
  • Delirium in the ICU
  • Patients’ need for sleep
  • Ventilator strategies

Chapters provide evidence based on expert opinion, principles derived from other disciplines and practical experience.

ICU Liberation: The Power of Pain Control, Minimal Sedation, and Early Mobility is available for purchase in the SCCM Store in print and as an eBook for $75 for members ($95 for nonmembers). If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

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Participate in Twitter Chat Centered on Sepsis

The Society of Critical Care Medicine (SCCM) is partnering with the U.S. Centers for Disease Control and Prevention (CDC) to hold a Twitter chat aimed at raising awareness about sepsis. The chat will take place from 1:00 p.m. to 2:00 p.m. Central Time on Thursday, September 10, 2015. This is a great opportunity to learn about best practices for detecting and treating sepsis. It is also a great opportunity to learn about pertinent sepsis-related resources. SCCM President Craig M. Coopersmith, MD, FCCM, will be fielding questions from participants throughout, so come prepared with any relevant questions you may have and make sure to use #SepsisChat in your tweets.

This Twitter chat is part of Sepsis Awareness Month, which was created to spread the word about this life-threatening condition.

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Application Deadline for THRIVE Grant is September 8, 2015

Apply by September 8, 2015, to be considered for the THRIVE Research Grant to Accelerate Recovery. Grant support will begin in January 2016.

Through generous funding from the Society of Critical Care Medicine (SCCM), the THRIVE Grant offers $50,000 to support SCCM members conducting research aimed at improving patient and family support after critical illness. Investigator-initiated research should help advance our understanding of survivorship from critical illness and improve the experiences of survivors and their families.

Eligible areas of investigation include:

  • Clinical interventions to improve patient experiences or outcomes
  • Identification of modifiable mechanisms or testing of innovations that promote recovery
  • Explorations of cultural and educational factors to facilitate networks and improve support among survivors

To begin the application process, log in to www.My.SCCM.org. Click on the “Submit an application for Vision Grant or THRIVE Grant here” link located in the right column. Note that you must be a current SCCM member to apply for the THRIVE Grant.

For further information on this grant and other THRIVE initiatives, visit www.sccm.org/THRIVE.

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SCCM Announces THRIVE Peer Support Collaborative Grant Awardees

Millions of patients each year survive a serious or life-threatening illness only to face an often painful and challenging course of recovery. In an effort to assist patients after an intensive care unit (ICU) discharge, the Society of Critical Care Medicine (SCCM) launched the THRIVE Initiative. A key component of this initiative is the newly minted THRIVE Peer Support Collaborative, which has SCCM partnering with six inaugural sites to foster a network of in-person support groups linking survivors of critical illness and their families. SCCM would like to formally congratulate all six grant awardee sites.

Dell Children’s Medical Center of Central Texas – Austin, Texas, USA

University of Washington/Harborview Medical Center – Seattle, Washington, USA

UC San Diego Medical Center – La Jolla, California, USA

Brigham and Women’s Hospital – Boston, Massachusetts, USA

NorthShore University HealthSystem – Evanston, Illinois, USA

Vanderbilt University Medical Center – Nashville, Tennessee, USA

The Collaborative, which will grow in subsequent years as additional sites are invited to participate, will enable the creation of face-to-face groups in which survivors offer each other mutual support and share solutions related to ICU recovery. The goal is not to fund ICU follow-up clinics but rather to develop peer-support models with strong survivor co-leadership as the foundation for growing the network. SCCM believes that ICU survivors have unique knowledge and skills that they can share with each other to help improve recovery. The THRIVE Initiative seeks to catalyze this sharing. In this fashion, SCCM hopes to rapidly advance the practice of peer-survivor support.

Learn more about the challenges faced by patients after ICU discharge by listening to this recent iCritical Care podcast.

SCCM Pod-287 Posttraumatic Stress Disorder in Critical Illness Survivors: A Meta-Analysis

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AMA Releases Article on New ECMO/ECLS CPT Codes

The American Medical Association (AMA) recently made available an article concerning new extracorporeal membrane oxygenation/extracorporeal life support Current Procedural Terminology (CPT®) codes.

Access this article by visiting the AMA website and clicking on the link in the right-hand column, CPT Codes For Extracorporeal Membrane Oxygenation-Extracorporeal Life Support. New users to the website will be prompted to create a free account with AMA to access the article. Existing users will need to sign in.

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