Tele–ICU Competencies

85 Pages·2011·27.16 MB·English

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October 2011 • Volume 31, No. 5
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ritical are urse
The journal for high acuity, progressive, and critical care
Tele–ICU
Competencies
Expediting
Laboratory
Test Results
Decreasing
Postoperative
Pneumonia
The Going
Home
Initiative
Legal Aspects
of End-of-Life
Care
Leadership
Orientation
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Iworked
with my
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to transform
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to work for
my patient.
We brought the family to the
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spirit of a Native-American
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Doing what’s right for patients and their families. That’s what we do.
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Editor JoAnnGrifAlspach,RN, MSN, EdD
Editorial Board
THOMAS AHRENS, RN, PhD, CCRN, CS BONNIE M. JENNINGS, RN, DNSc
Clinical Specialist/Research Scientist, Nursing Department Col, US Army Nurse Corps, Deputy Director, Health Program Analysis
Barnes-Jewish Hospital, St Louis, MO and Evaluation, Office of the Assistant Secretary of Defense for Health
Affairs/TRICARE Management Activity
SUSAN D. BELL, RN, MS, CNRN, CNP
Nurse Practitioner, Neurosurgery SUSAN G. TREVITHICK, RN, MS, CNA
Ohio State University Medical Center, Columbus, OH Clinical Support Manager, Specialty Care Center
Salt Lake City Veterans Administration Medical Center, UT
SUZETTE CARDIN, RN, DNSc, CNAA
Adjunct Assistant Professor, Graduate Nursing Administration Program GLENNA TRAIGER, RN, MSN, CCRN
UCLA School of Nursing, Los Angeles, CA Clinical Nurse Specialist, Pulmonary Arterial Hypertension Program
Greater LA VA Medical Center, Los Angeles, CA
Academic Education Evidence-Based Practice Legal Issues Pediatric Care
CHARLENE A. WINTERS,PHD, ACNS-BC PAULA LUSARDI, RN, PhD, CCRN, CCNS CLAIRE M. MCGOWAN, RN, MS, JD, ACNP, CCRN MARY FRANCES D. PATE,RN, DSN, CNS
Advanced Practice Family-Centered Care Management/Administration Postanesthesia Care
CHRIS WINKELMAN,RN, PhD, CCRN, ACNP JUDY DAVIDSON, RN, MS, CCRN ELIZABETH J. THOMPSON, RN,MBA, CCRN ANGELA SMITH COLLINS,RN, DNS, CCNS, ACNS, BC
BPAesTt RPIrCacIAti cReAs iDnO CVriItCicHal, CRNar,e MSN, CNS, FCCM GRACOaNsStPEro-MBinCAt, eRCsYCti RnKNaOl, EDCHCisNLo SrLdEeEr,s RN-CNS, MSN, MLOilUitIaSr yS TCOriUticTa Ll TCCar Ae NNCur, sRinNg, -MArSm, CyEN PPKCrAoCTgNHr,e LCssECiEvNNeS C Mar. eSTACY, RN, PhD, CNS, CCRN,
Cardiovascular Medicine Genetics Neonatal Care Pulmonary Care
DEBORAH KLEIN,RN, MSN, APRN-BC, CCRN DENNIS CHEEK, RN, PhD JUDY VERGER, RN, PhD, CRNP LESLIE A. SWADENER-CULPEPPER, RN, MSN,
CCRN, CCNS
Cardiovascular Surgery Geriatrics Neurology/Neurosurgery
PAMELA SHUMATE, RN, MSN, CCRN-CMC SONYA R. HARDIN, RN, PhD, CCRN, ACNS-BC, NP-C JUDI L. KURIC, RN, MSN, DNP, ACNP-BC, CNRN Skin and Wound Care
KAREN L. COOPER, RN, MSN, CCRN, CNS, WOCN
ELICNGDs Aan BdE PNaTcOemNa, kReNrs, MPS, CCRN HCAemROatLo lAo.g RyAUEN, RN, MS, CCRN, CCNS, PCCN NROurCsHinEgL GLrEa Rnd. A RRoMunOdLsA, RN, MSN, CCRN TSUelSeA-INCU F .E GnhOaRnAceNm, RenNt,s MSN
EMmICerHgEenLEcy K DOeSpIaNrtSmKeI,n RtN, MSN, MBA, CCRN, CEN IFmREmDuAno DloEgKyEYSER GANZ, RN, PhD PTaRiAn CMYa AnaNgNem PeAnStEK, RN, MSN, CCRN, CIMI TSToExiPcHolEoNgy P. WOOD,MS, EMT-P
Infection Control
Ethical Issues SUSAN K. B. JONES, RN, PhD(c), APN, CCRN-P, Patient Safety Trauma
CATHERINE ROBICHAUX,RN, PhD, CCRN, CNS CCNS-P ELIZABETH A. MATTOX,RN, MSN, ARNP MICHAEL W. DAY, RN, MSN, CCRN
Editorial Office
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Secretary MAUREEN SECKEL, RN, MSN, APN, ACNS-BC, CCRN, CCNS Managing Editor REBECKA WULF
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LINDA MARTINEZ, RN, MSN, ACNS-BC-CMC
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a better sense

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The journal for high acuity, progressive, and critical care
October 2011 • Volume 31, Number 5
Contents
Cover Article
w CEContinuing Education
A New View: Tele–Intensive Care Unit
Competencies
Susan F. Goran
17
page
Cover illustration by Gary Chike
OnlineNOW
16
Abstracts of articles available exclusively online at www.ccnonline.org
page
w CEContinuing Education
Essential Nursing Competencies for Genetics and Genomics: Implications for Critical Care
Lynnette Howington, Kristina Riddlesperger, Dennis J. Cheek e1
Critically Ill Patients With H1N1 Influenza A Undergoing Extracorporeal Membrane Oxygenation
Christopher Bibro, Christine Lasich, Frank Rickman, Jr, Nichole E. Foley, Sujen K. Kunugiyama, Ember Moore, Amy O’Brien,
Natalie Sherman, Christine S. Schulman e8
Features
Code Labs: Expediting Laboratory Test Results During a Code
30
Shannon K. Hurliman and Kristin Paston
page
Aspiration Prevention Protocol:
Decreasing Postoperative Pneumonia in Heart Surgery Patients
38
Bobbie Starks and Christy Harbert
page
4 CriticalCareNurse Vol 31, No. 5, OCTOBER 2011 www.ccnonline.org
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TOC 10_11pgs_04_06_TOC10_11 9/8/11 9:46 AM Page 6
C C N
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The journal for high acuity, progressive, and critical care
October 2011 • Volume 31, Number 5
30 74 77
page page page
Code Labs In Our Unit Book Reviews
Columns Departments
Guest Editorial
w CEContinuing Education Long-Term Consequences of Critical Illness:
Evidence-Based Practice
A New Opportunity for High-Impact Critical
The Going Home Initiative: Getting Critical Care Nurses
Care Patients Home With Hospice Maurene A. Harvey and Judy Davidson page 12
Paula Lusardi, Paul Jodka, Mark Stambovsky, Beth Stadnicki, Ask the Experts
Betty Babb, Danielle Plouffe, Nancy Doubleday, 46
Ambulating With Pulmonary Artery
Zophia Pizlak, Katherine Walles, Martin Montonye
page or Femoral Catheters in Place
70
Chris Winkelman
page
Best Practices in Critical Care
Enhancing Leadership Orientation In Our Unit
Through Simulation Skin Care Oktoberfest: A Creative Approach
Patricia Radovich, Janice Palaganas, Jennifer Kiemeney, 58 to Pressure Ulcer Prevention Education in a
Bradley Strother, Brenda Bruneau, Lori Hamilton Pediatric Intensive Care Unit
page
Michael Scott, Tracy Ann Pasek, Allison Lancas,
74
Legal Issues Ashley Duke, Carol Vetterly page
Legal Aspects of End-of-Life Care
64
Also in This Issue
Claire M. McGowan
page
Contributors 9
page
Book Reviews 77
page
Education Directory 79
page
I Am a Critical Care Nurse 80
page
6 CriticalCareNurse Vol 31, No. 5, OCTOBER 2011 www.ccnonline.org
07_08_HospiraAd10_11_07_08_HospiraAd10_11 9/8/11 9:48 AM Page 7
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Clinically significant episodes of bradycardia,
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Initially intubated and mechanically ventilated

patients during treatment in an intensive care Moderate blood pressure and heart rate
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Administer Precedex® by continuous infusion

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Please see the brief summary of Prescribing Information on adjacent page.
References: 1. Based on increases in weight of active ingredient sold (either mcg or mg). IMS Health National Sales
Perspective 2Q 2009. US nonretail market, all channels injectables. 2. Precedex [package insert]. Lake Forest, IL: Hospira,
Inc; 2008. 3. Kamibayashi T, Maze M. Clinical uses of α-adrenergic agonists. Anesthesiology. 2000;93:1345-1349.
2 For more information on Advancing WellnessTM,
contact your Hospira representative
Hospira, Inc. 275 North Field Drive, Lake Forest, IL 60045 at 1-877-9HOSPIRA (1-877-946-7747)
P10-2637/R1, Mar., 11. Printed in the USA. or visit www.hospira.com.
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