Webcast: Patient-Centered Approach to Transition after Catastrophic Injury

Patients who have experienced a catastrophic injury have profound care needs and face a lifetime of risk for life-threatening medical problems. In the webcast, Patient-Centered Approach to Community Transition after Catastrophic Injury, the latest offering from the Society of Critical Care Medicine’s (SCCM) Project Dispatch series, the transition home and into the community for these patients will be discussed. Can a patient- and family-centered approach to education, mentoring and support be effective in minimizing hospital readmissions for these patients?

Michael Jones, PhD, FACRM, and Julie Gassaway, MS, RN, of the Shepherd Center in Atlanta, Georgia, USA, have received a Patient-Centered Outcomes Research Institute (PCORI) grant to examine just that question. They also investigated the sense of self-sufficiency and intensity of community participation in patients with spinal cord injury. The Shepherd Center is one of only two specialty hospitals that provide rehabilitation for patients with acute brain and spinal cord injuries. In this webcast, Dr. Jones and Ms. Gassaway will share patient feedback on how the rehabilitation experience could be improved, discuss the patient- and family-centered approach to education, peer counseling, discharge planning, and support, and present preliminary results from their research. The presentation will be followed by an opportunity for audience questions.

Learning Objectives

  • Outline the challenges for patients and their families in the wake of catastrophic injury
  • Apply a patient- and family-centered approach to support the patient’s transition to home and community
  • Develop programs that benefit patients and families in the participants’ own communities

This webcast will take place on Wednesday, October 15, 2014, at 12:30 p.m. Central Time.

Register online today using your customer ID and password. Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

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

This webcast was organized by SCCM’s Project Dispatch. Project Dispatch focuses on the patient and family experience. The initiative highlights a number of patient-centered care approaches to encourage awareness and adoption at the bedside among SCCM’s members. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Incidence of Subdural Hemorrhage in Infants with Congenital Heart Disease

Subdural hemorrhage (SDH) in infants is commonly associated with nonaccidental trauma and “shaken baby syndrome,” and some reports suggest that SDH may appear in susceptible infants who have suffered apnea or significant hypoxia. Although generally asymptomatic, SDH related to birth trauma has also been reported to be common. Kelly and colleagues sought to determine the true incidence of SDH in infancy by looking at pre- and postoperative infants who have undergone a repair of congenital heart disease (CHD). In addition, the authors sought an association between the development of SDH and the presence of hypoxia.

The authors found that asymptomatic SDH was common in infants with CHD at a rate similar to those without CHD. These SDHs were typically small and resolved within three months of birth. The authors were unable to demonstrate any association between hypoxia and SDH in this cohort. However, the ability to generalize these results is limited due to the nature of the selected patient population.

Read the full Concise Critical Appraisal by logging into 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.

Hospitals Report Results of SSC Implementation

Four hospitals in Detroit reported their success in implementing the Surviving Sepsis Campaign (SSC), demonstrating improved frequency of blood culture testing before antibiotic administration and significant improvement in the time to antibiotic treatment — from a mean of approximately 182 minutes to 92 minutes. The four hospitals participated in a study published in the Journal for Healthcare Quality.

“While guidelines provide a roadmap for patient care, successful implementation relies on consistent patterns of clinician practice to achieve optimal outcomes,” said lead author of the study and Society of Critical Care Medicine (SCCM) member Maria Teresa Palleschi, CCRN, DNP, ACNP, of Detroit Medical Center. “Educating staff is essential to the process of improving patient outcomes, and the results of our study showed the relationship between education and sampling of lactate and blood cultures, as well as timeliness of antibiotic administration.”

Learn more about the tools needed to implement the SSC at www.survivingsepsis.org and get involved in the community at www.facebook.com/survivingsepsis.

WAAAR Issues Declaration Against Antibiotic Resistance

The World Alliance Against Antibiotic Resistance (WAAAR) recently issued a declaration against antibiotic resistance (ABR). The declaration is intended to encourage dialogue centered on the public health threat posed by ABR. Concerted action by medical organizations, policymakers, patient advocacy groups, pharmaceutical companies, and the general population is needed to mitigate this threat, the declaration states.

By any measure, ABR exacts a tremendous cost. According to the declaration, thousands in Europe and the United States alone die each year from infections caused by resistant bacteria. The declaration further notes that a direct correlation exists between ABR and the volume of antibiotics dispensed. Widespread use ultimately promotes the development and dissemination of antimicrobial resistance. Wise antibiotic use and corresponding preservation policies are needed to counter this, especially given the relative dearth of new antibiotics in the pipeline.

WAAAR is a group of 700 individuals from 55 countries that represents physicians, veterinarians, microbiologists, surgeons, pharmacists, nurses, evolutionary biologists, ecologists, environmentalists, and patient advocacy groups.

Discuss antibiotic resistance and the WAAAR declaration at the SCCM eCommunity.

Drug Shortage Alert: Alternative Medications for Procedural Sedation

The Society of Critical Care Medicine’s Drug Shortages Task Force has developed a guideline that can be referred to for options if a drug shortage arises that affects commonly used medications for procedural sedation.

The alert, Alternative Medications for Procedural Sedation, includes pertinent information that can help guide critical care practitioners. The characteristics of an ideal drug for procedural sedation are listed. Risks associated with administering alternative medications are also provided.

Visit www.sccm.org/currentissues to access all Drug Shortage Alerts, including those addressing:

  • Electrolyte Medication Shortages
  • Intravenous Sodium Bicarbonate
  • Web Resources
  • Intravenous Loop Diuretics
  • General Considerations

Explore Arizona’s Main Attractions at Congress with SCCM’s Organized Tours

Arizona is known for its vast desert landscape, magnificent rock canyons and formations and rich Native American history. See the sights and explore all that Arizona has to offer during the Society of Critical Care Medicine’s (SCCM) 44th Critical Care Congress by participating in one of the following tours:

Half-Day Tours

Heard Museum
Built in the early 1900s, the internationally acclaimed Heard Museum provides a unique glimpse into the fascinating cultures and art of Native Americans of the Southwest.

Horseback Riding
Relax as professional guides take you on the most scenic horseback riding trails in Arizona.

Hot Air Balloon Ride
Enjoy an awe-inspiring flight over the scenic desert floor.

Desert Four-Wheel Drive
Head into the heart of cactus country for a memory-making four-wheel drive tour.

Full-Day Tours

Grand Canyon – South Rim by Land
Explore the spectacular panorama of the mystical red-rock monuments of Sedona, Flagstaff and, finally, the Grand Canyon.

Sedona/Jerome
Join us for a day in northern Arizona discovering the enchanting city of Sedona and Arizona’s best kept secret, Jerome.

For additional details, or to register for tours, visit www.sccm.org/Congress.

The Society’s annual Congress is the largest multiprofessional critical care event of the year, bringing together more than 6,000 critical care clinicians from around the world. This five-day event will offer opportunities to explore breakthroughs in research, share creative and stimulating ideas, make valuable connections, and obtain inspired perspectives from all members of the multidisciplinary, multiprofessional critical care team.

Register online for Congress by using your customer ID and password, or contact SCCM Customer Service at +1 847 827-6888.

For information on hotel and travel reservations, visit www.sccm.org/Congress.

Webcasts: “Tree of Life” Event and Transition After Catastrophic Injury

The Society of Critical Care Medicine’s (SCCM) Project Dispatch series will present two non-continuing medical education webcasts in the upcoming weeks.  Complimentary registration for both is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ). If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

The “Tree of Life” Memorial Event: Meaningful for Families
Wednesday, September 24, 2014
12:00 p.m. Central Time
Register Online

To honor the unselfish acts of organ donation in the face of overwhelming grief, University Hospital in San Antonio, Texas, USA, created the “Tree of Life” Memorial Event following the deaths of two young men in 2005. Both families independently decided to donate their loved ones’ organs so that something good might come from such a devastating loss. These actions started a special journey for these men’s families and the hospital staff that cared for them.

In this webcast, Charles Reed, PhD, RN, CNRN, will discuss the development of the “Tree of Life” Memorial Event, including how the program has grown and become an integral part of the hospital’s commitment to patients, their families and the community.

Learning Objectives

  • Describe the “Tree of Life” Memorial Event and its impact on families and the healthcare institution
  • Examine how this program can be a model for others
  • Evaluate the impact the program has on families, staff and the community

Patient-Centered Approach to Community Transition After Catastrophic Injury
Wednesday, October 15, 2014
12:30 p.m. Central Time
Register Online

One of the greatest challenges for patients and their families after a catastrophic injury is the transition home and back into the community. These patients have profound care needs and face a lifetime of risk for developing life-threatening medical problems. Can a patient- and family-centered approach to education, mentoring and support be effective in minimizing hospital readmissions for patients?

Michael Jones, PhD, FACRM, and Julie Gassaway, MS, RN, of the Shepherd Center in Atlanta, Georgia, USA, have received a Patient-Centered Outcomes Research Institute (PCORI) grant to examine just that question. They also investigated the sense of self-sufficiency and intensity of community participation for patients with spinal cord injury. The Shepherd Center is one of only two specialty hospitals that provide rehabilitation for patients with acute brain and spinal cord injuries. In this webcast, Dr. Jones and Ms. Gassaway will share patient feedback on how the rehabilitation experience could be improved, discuss the patient- and family-centered approach to education, peer counseling, discharge planning, and support, and present preliminary results from their research.

Learning Objectives

  • Outline the challenges for patients and their families in the wake of catastrophic injury
  • Apply a patient- and family-centered approach to support the patient’s transition to home and community
  • Develop programs that benefit patients and families in the participants’ own communities

These webcasts were organized by SCCM’s Project Dispatch. Project Dispatch focuses on the patient and family experience. The initiative highlights a number of patient-centered care approaches to encourage awareness and adoption at the bedside among SCCM’s members. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Construct a Service Model for Advanced Practice Providers

Learn the components to building a successful advanced practice provider (APP) service model during the Society of Critical Care Medicine’s (SCCM) Advanced Practice Providers: Administration, Leadership and Outcomes series. This four-part educational series features three webcasts and a live half-day course.

Developed by SCCM’s eLearning Nurse Practitioner (NP)/Physician Assistant (PA) Task Force, each component of the series includes speakers who bring their local and national expertise to a variety of subject areas, providing participants with the comprehensive view needed to establish a multiprofessional intensive care unit (ICU) provider team.

Webcasts
The webcasts cover a spectrum of topics on designing, initiating and maintaining a skilled APP program.

Developing Formal Orientation and Onboarding for Advanced Practice Providers
Tuesday, September 30, 2014
11:00 a.m. – 12:00 p.m. Central Time

Ensuring Initial and Ongoing Competency of Advanced Practice Providers in the ICU
Wednesday, October 8, 2014
12:00 p.m. – 1:30 p.m. Central Time

Financial and Administrative Considerations for the Development of an ICU NP/PA Practice
Originally broadcasted on Thursday, August 21, 2014
Once registered, you can access the webcast On Demand by logging into www.MySCCM.org

Live Event
The half-day course will be held at SCCM’s 2015 Critical Care Congress and will focus on identifying care models that integrate APPs in the ICU, national trends in clinical nurse specialist, NP and PA practice, fiscal approaches, and benchmarking to assess program value.

Advanced Practice Providers: Administration, Leadership and Outcomes
Saturday, January 17, 2015
8:00 a.m. – 12:00 p.m. Mountain Standard Time
Phoenix Convention Center
Phoenix, Arizona, USA

Register online today using your customer ID and password. The registration fee is $295 ($348 for nonmembers) and includes all three webcasts, On Demand access to content after the webcasts and the live event. Attendees of the live event are eligible to receive continuing education credit. Components of the series are not available to purchase separately.

Please contact SCCM Customer Service at +1 847 827-6888 with any questions.

If you plan to attend this course in conjunction with Congress, register at www.sccm.org/Congress.

Continuous vs. Intermittent Renal Replacement Therapy for Acute Renal Failure

Acute renal failure (ARF) requiring dialysis is a common and frequently lethal problem encountered in the intensive care unit (ICU). Despite two multicenter trials and a meta-analysis, a survival benefit for continuous venovenous hemofiltration (CVVH) versus intermittent hemodialysis (IHD) renal replacement therapy has not been convincingly demonstrated. Schefold and colleagues conducted the CONVINT trial (continuous versus intermittent renal replacement therapy on the outcome of critically ill patients with acute renal failure) to study the impact of the initial choice of renal replacement therapy on patient outcomes in a medical ICU.

The authors concluded that IHD and CVVH might be considered equivalent approaches for a population of critically ill patients with dialysis-dependent ARF treated in a medical ICU. The study has several major limitations. For example, CVVH dosing practices used may differ from those employed at other institutions, potentially limiting the external generalizability. Nevertheless, data from this trial add to the accumulating evidence that CVVH may be equivalent to IHD in selected ICU populations.

Read the full Concise Critical Appraisal by logging into 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.

Palliative Sedation in the ICU On Demand Is Now Available

The recently broadcast Palliative Sedation in the ICU webcast is now available for purchase On Demand.

In this webcast from the Society of Critical Care Medicine’s (SCCM) Controversies in Critical Care series, Douglas B. White, MD, begins by introducing the topic of palliative sedation. Expert faculty then explore when and under what conditions such treatment is warranted and what types of sedation regimens are included under this rubric. Margaret L. Campbell, PhD, RN, FPCN, discusses clinical considerations for use of palliative sedation in the ICU, and Mark Siegel, MD, reviews the ethical foundations and potential pitfalls with this form of sedation.

Palliative Sedation in the ICU On Demand gives you access to videos containing both slides and lectures from every session in a searchable format, making it the next best thing to attending the live event. Once you’ve purchased Palliative Sedation in the ICU On Demand, you can access the materials as often as you like by logging into www.MySCCM.org.

Palliative Sedation in the ICU On Demand is available for purchase in the SCCM store.  The registration rate is just $35 for members ($45 for nonmembers).

If you participated in the live event, your subscription to the On Demand service was included in your registration fee. The materials can be accessed by logging into www.MySCCM.org with your customer ID and password.

The Controversies in Critical Care webcast series is a joint project of the SCCM Scientific Review Committee and the American College of Critical Care Medicine’s Ethics Committee. This series is intended to provide insight into topics in critical care medicine for which there is no clear consensus or unequivocal evidence for guiding practice decisions.

Registration Open for Webcast on “Tree of Life” Memorial Event

Registration is now open for The “Tree of Life” Memorial Event: Meaningful for Families, the latest webcast from the Society of Critical Care Medicine’s (SCCM) Project Dispatch series. Tragic, unexpected loss of a loved one is never easy for families, but they may honor their loved one’s wishes to help others by giving the gift of life through organ donation. In 2005, two young men with non-survivable injuries were airlifted to the surgical trauma intensive care unit at University Hospital in San Antonio, Texas, USA, starting a special journey for these men’s families and the hospital staff that cared for them. Both families independently decided to donate their loved ones’ organs so that something good might come from such a devastating loss.

To honor these unselfish acts of organ donation in the face of overwhelming grief, the hospital created the “Tree of Life“ Memorial Event, which serves as a living monument, recognizing the organ donor’s life and acknowledging the subsequent gift. The families are grateful that the hospital honors their loved ones and report that the invitation to the annual event “makes you feel good that people haven’t forgotten you.”

In this webcast, Charles Reed, PhD, RN, CNRN, will discuss the development of the “Tree of Life” Memorial Event, including how the program has grown and become an integral part of the hospital’s commitment to patients, their families and the community. Complimentary registration is made possible by a grant from the Agency for Healthcare Research and Quality (AHRQ).

Learning Objectives

  • Describe the “Tree of Life” Memorial Event and its impact on families and the healthcare institution
  • Examine how this program can be a model for others
  • Evaluate the impact the program has on families, staff and the community

This webcast will take place on Wednesday, September 24, 2014, at 1:00 p.m. Central Time.

Register online today using your Customer ID and password.

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

This webcast was organized by the Society of Critical Care Medicine’s Project Dispatch.  Project Dispatch aims to improve the quality, efficacy, accessibility, and cost-effectiveness of healthcare in the United States by developing and distributing resources for critical care clinicians focused on patient-centered research. This project is supported by grant number R18HS21940 from AHRQ. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

Earn CME/CE Credit with the 2014 Congress Review

Earn continuing medical education/continuing education credit with the 2014 Congress Review, now available in the Society of Critical Care Medicine (SCCM) store. This complimentary online course reviews key presentations from the 43rd Critical Care Congress held in San Francisco, California, USA.

Supported by education grants from Hospira, Inc. and Otsuka America Pharmaceutical, Inc., the sessions for this course include:

  • Strategies to Optimize Physical and Psychological Functioning in the ICU Patient
  • Hyponatremia in the Critical Care Patient: First Do No Harm
  • Pediatric Acute Lung Injury
  • Late Breaker: The Latest in Critical Care Research
  • Drug Shortages: Lessons Learned

At the conclusion of this activity, participants should be able to:

  • Discuss the risks and treatment options for a critically ill patient with hyponatremia
  • Discuss strategies to decrease the impact of pain, sedation and delirium on ICU patients
  • Review consensus criteria and treatment options for pediatric acute lung injury
  • Define how demand elasticity encourages overutilization in the ICU
  • Discuss the impact of drug shortages on patient outcomes

To participate in this activity, purchase this free course from the SCCM store. After earning a passing score of 70% or higher on the post-test, you will be eligible to claim credit for this activity.

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

Is Tidal Volume Associated with Mortality in Mechanically Ventilated Children?

Since the landmark articles by the ARDS Network in 1998 and 2000, low tidal volume (Vt) ventilation in critically ill adults has become a standard intervention to prevent ventilator-induced lung injury. However, despite the lack of confirmatory data in critically ill children, the practice of using low Vt has been readily adopted in most — if not all — mechanically ventilated pediatric patients. This systematic review by de Jager et al attempted to find an association between various cutoff values for Vt and mortality in mechanically ventilated patients younger than 18 years. The authors searched MEDLINE, EMBASE and CINAHL for randomized clinical trials and observational studies, ultimately analyzing eight studies.

A relationship between Vt and mortality in mechanically ventilated children could not be identified, irrespective of the severity of disease. The reasons for this are multifactorial. Most importantly, the authors admit to significant heterogeneity among the pooled studies, which clearly affected their ability to demonstrate any association between Vt and mortality.

Read the full Concise Critical Appraisal by logging into 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.

Project Dispatch Offers up Complimentary Educational Material

The Society of Critical Care Medicine’s (SCCM) Project Dispatch initiative aims to put a spotlight on efforts to improve patient- and family-centered care by disseminating the latest research in this exciting field. Complimentary educational material is consequently made available with regularity. One recently released offering centers on the efficacy of music and pet therapy in the intensive care unit.

Project Dispatch is supported by grant number R18HS21940 from the Agency for Healthcare Research and Quality (AHRQ). The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ.

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