Critical Care Weekly Pulse Weekly

The Critical Care Weekly Pulse™, a weekly e-news publication packed with career empowerment resources including the latest clinical, industry, and product news, clinical education, market research, and of course, the most recently posted jobs requiring expertise in the critical care nursing and medicine. Over 10,000 clinicians now receive the Critical Care Weekly Pulse.

Read the most recent issue of the Critical Care Weekly Pulse™

Receive your own complimentary subscription to the Critical Care Weekly Pulse™

Sign Up Now!

Featured Articles

August 8, 2018

Clinical Education Webcast: "Stressing the Dressing: Reducing Vascular Access Device Complications" Featuring, Russel Nassof, JD - Space is limited!

Register Now

PPE Donning and Doffing Reveals Gaps in Knowledge and Practice

The best-designed and engineered items of personal protective equipment (PPE) will fail healthcare workers and their patients if the PPE is donned or doffed incorrectly and contamination is spread. Knowing that seeing is believing, researchers at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital secured the consent of healthcare personnel to videotape how they gowned and gloved, and other related clinical practices. Kang, et al. (2017) discovered that healthcare personnel contaminated themselves in almost 80 percent of the PPE simulations. Read More

Travel Time Has Major Impact on Nurse Staffing Ratios in Neurocritical Care Units

For specialist nurses on neurocritical care units, accompanying patients for imaging scans and other procedures has a major impact on nurse staffing ratios. "Patients in a neurologic critical care unit require more staffing to account for the frequent neurologic assessments, charting, and traveling," according to the workflow study. The study led to the addition of staff members, including a new "circulating nurse" position, with the goals of improving patient care and nurse retention rates.  Read More

Not in The Medical Textbooks: How Doctors Find a Way to Tell Families That Their Relative Has Died

One of the most overlooked aspects of medicine at public hospitals across India is the communication of the news of death. Unfortunately, there is nothing in the medical education curriculum about how to tell a patient’s family, friends and attendants that he or she has died. There is little to prepare doctors for the various difficulties they may face in conveying such news. Across the country, the news of death has increasingly led to violence against doctors. Read More

Antimicrobial Lock Solutions Are Cost-Effective for Preventing Central Line-Associated Bloodstream Infections

Antimicrobial lock solutions are an effective clinical and cost-effective strategy for preventing central line-associated bloodstream infections (CLABSI), according to new findings published in Clinical Infectious Diseases. Recent studies show that the prophylactic use of antimicrobial locks can reduce the incidence of CLABSI, and the Centers for Disease Control and Prevention (CDC) recommends their use in patients who have experienced multiple prior episodes of CLABSI. Read More

  • August 1, 2018

    Clinical Education Webcast: "Stressing the Dressing: Reducing Vascular Access Device Complications" Featuring, Russel Nassof, JD - Space is limited!

    Register Now

    Single-Room ICU Design Contributes to the Reduction of Cross-Transmission of MDROs

    Cross-transmission of nosocomial pathogens occurs frequently in intensive care units (ICU). The aim of this study was to investigate whether the introduction of a single room policy resulted in a decrease in transmission of multidrug-resistant (MDR) bacteria in an ICU. The researchers conclude that single-room ICU design contributes significantly to the reduction of cross transmission of MRD-bacteria. Read More

    Adrenaline Use Discouraged as Heart Attack Treatment

    A new study shows that using adrenaline in cardiac arrests nearly doubles the survivors’ risk of severe brain damage. The study included 8,007 patients in cardiac arrest who were allocated randomly to be given either adrenaline or a salt-water placebo. All those involved in the trial, including ambulance crews and paramedics, were unaware which of the two treatments the patient received. Read More

    New Prevention Bundle Significantly Reduces Pediatric Health Care-Associated Viral Infections

    Pediatric health care-associated viral infections, or HAVIs, were significantly reduced by the development, implementation and refinement of targeted prevention practices, according to findings published in Infection Control & Hospital Epidemiology. “The application of standard prevention bundles has proven successful in the reduction of other health care-associated infections, such as central line-associated bloodstream infections or catheter-associated urinary tract infections, but the application of a comprehensive bundle to prevent HAVI has not been previously described." Read More

    Nursing Notes Can Predict Survival Rates of ICU Patients

    Sentiments in the notes of ICU nurses are good indicators of whether patients will survive, according to researchers from the University of Waterloo in Ontario, Canada. Hospitals can already predict the 30-day survival of ICU patient through severity of illness scores, which include lab results, vital signs and physiological and demographic characteristics gathered within 24 hours of admission. Using a large publicly available ICU database, researchers looked at patient data from 2001 to 2012, considering 27,000 patients and the nursing notes. The study was recently published in the journal PLoS One. Read More

  • July 25, 2018

    Clinical Education Webcast: "Stressing the Dressing: Reducing Vascular Access Device Complications" Featuring, Russel Nassof, JD - Space is limited!

    Register Now

    Reducing Delirium in Older Patients After Surgery

    A drug that reduces delirium in postoperative patients may work by preventing the overactivity of certain receptors in brain cells, according to a new study published in June 2018 in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA). The researchers say the findings could lead to more widespread use of the drug, dexmedetomidine, and speed the development of new treatments for postoperative delirium with fewer side effects. Read More

    Pediatric Sepsis Care Within an Hour Decreases Chance of Death, Largest Ever Analysis Finds

    More than 1 in 10 children hospitalized with sepsis die, but when a series of clinical treatments and tests is completed within an hour of its detection, the chances of survival increase considerably, according to a new analysis led by the University of Pittsburgh School of Medicine. Read More

    Diaries Can Help ICU Patients, Families

    The care of patients in the Intensive Care Unit involves some advanced measures, like sedation. That can lead to some frightening memories and some mental health concerns after discharge. "Patients have a number of issues after they've been released from ICU, including depression and anxiety," CRMC Critical Care Educator April Jarvis said. It's called Post-Intensive Care Syndrome, and it's so new, there isn't a lot of data on it. Craig heard an idea at a conference about how something as simple as keeping a diary can help patients. Read More

    Infection Prevention Staffing Needs May Be Underestimated

    A comprehensive assessment of health care organization composition and structure is necessary before determining infection preventionist (IP) staffing needs, according to a study published recently in the American Journal of Infection Control. Providence St. Joseph Health System in Renton, Wash., and colleagues describe a large nonprofit health care system's approach at quantifying the actual number of IP and relative support staff needed to build and sustain effective infection prevention programs. Read More

  • July 19, 2018

    Intensive Care Patients' Muscles Unable to Use Fats for Energy

    The muscles of people in intensive care are less able to use fats for energy, contributing to extensive loss of muscle mass, finds a new study co-led by UCL, King's College London and Guy's and St Thomas' NHS Foundation Trust. Intensive care patients can lose 20% of their muscle mass in just 10 days, which can contribute to long-term disability. Nutrition and exercise programmes designed to prevent this muscle loss have largely been unsuccessful, and this new finding, published in Thorax, helps explain why. Read More

    Probiotic-Based Sanitation Reduces Hospital Infections Better Than Chlorine

    The Probiotic Cleaning Hygiene System (PCHS), a microbial-based decontamination strategy which is comprised of detergents that contain spores of Bacillus probiotics, is an effective and safe system for controlling contamination in the hospital setting and effectively reducing the risk of healthcare-associated infections (HAIs), according to a multicenter study published in PLoS One. Additionally, the probiotic-based cleansing system demonstrated little to no impact on worsening the risk of antibiotic resistance, which is a common issue associated with chemical-based cleansers. Read More

    The Modern Day Critical Care Team and Their Charge

    When pediatric critical care began, the major interventions were limited to endotracheal intubation, mechanical ventilation, volume resuscitation, and cardiac infusions. The primary outcome desired at that time was survival. As diagnostics, monitoring technology, and pharmaceutical options improved, along with our understanding of fundamental pediatric physiology, the focus of outcomes has evolved from survival alone to the functional status of survivors of critical illness. Read More

    Over Half Of Patients And Families Hesitate To Raise ICU Safety Concerns, Study Finds

    Imagine you're in the intensive care unit at the bedside of your loved one, and you think you see a medical mistake — a wrong pill, an unwashed hand. Do you speak up? Even if you're afraid that might annoy or alienate the medical team? It's a delicate question, and a new study out of Beth Israel Deaconess Medical Center — the first ICU study of its kind — documents just how delicate. The researchers surveyed more than 100 family members in the ICU and more than 1,000 online about whether they'd feel comfortable speaking up about various concerns. Read More

  • July 11, 2018

    A Taste of Flight Medicine: Nursing Students Learn What it's Like to Work Inside an Air Ambulance

    About 50 nursing students saw what it’s like Thursday to work inside the confined space of an air ambulance. A team from IU Health Lifeline Critical Care Transport landed at Ivy Tech’s south campus in the Vigo County Industrial Park and allowed students to look inside the high-tech helicopter. Flight nurse Blake Randolph said the teams work in 12-hour shifts, and the job is not one for beginners in the nursing field. Read More

    Microfluidic Chip to Detect Sepsis Proves Successful in Clinical Study

    Two years after inventing a microfluidic chip believed to help detect a life-threatening blood infection, researchers in the Texas Tech University Department of Chemistry & Biochemistry and the Texas Tech University Health Sciences Center (TTUHSC) are finally seeing their product work successfully for human patients. The chip, invented by associate professor Dimitri Pappas and graduate student Ye Zhang, detects sepsis, a potentially fatal condition in which the body's immune system goes into overdrive trying to kill a blood-borne bacterial infection. Read More

    Top Stories in Infectious Disease: CMS Policy Fails to Significantly Impact Infection Prevention, New App Developed for Deciding Antibiotic Treatments

    Among the top stories in infectious disease is the impact of CMS policy on infection prevention measures, the results of using an institution-specific antibiotic app, and new developments in the quest for a Zika vaccine. Other top stories include the first known case of pre-exposure prophylaxis failure in a developing country and the discovery that most armadillos in a certain region of the Brazilian Amazon carry leprosy. Read More

    Audit And Feedback Does Not Increase ICU Mortality

    Audit and feedback as part of antimicrobial stewardship programs has no impact on mortality rates in the ICU and can be safely implemented in this setting, according findings from a systematic review and meta-analysis published in Clinical Infectious Diseases. “The best available data does not suggest that antimicrobial stewardship, in the form of audit and feedback, significantly increases or decreases mortality in the ICU setting.” Read More

  • July 5, 2018

    4 Ways Nurses Can Fight Alarm Fatigue

    The American Association of Critical Care Nurses recently released a practice alert to help hospitals manage the clinical alarms that notify providers when patients' conditions change. The flood of noisy alarms during long shifts often results in providers feeling fatigued, delaying or reducing their response to the alarms, which threatens patient safety.The nurse association's alert is meant “to help nurses provide the safest patient care possible when managing clinical alarms in acute and critical care environments." Read More

    Hospitals Are Learning From Industry How to Cut Medical Errors

    When Virginia Mason committed itself to improving safety. It used an unlikely model: the Toyota Production System (TPS), the Japanese carmaker’s “lean” manufacturing techniques. Nearly every part of the hospital, from radiology to recruitment, was analysed and standardised. Staff were trained to raise safety concerns. Today Virginia Mason prides itself on its safety record—and sells its take on Toyota to hospitals across the world. Read More

    Technology to Help Busy Nurses Keep an Eye on Elderly has Seen Number of Falls Decrease

    El Camino Hospital, in the heart of Silicon Valley, has a problem. Its nurses - tending to patients amid a chorus of machines, monitors and devices - are only human. One missed signal from, say, a call light - the bedside button that patients press when they need help - could set in motion a chain of actions that end in a fall. "As fast as we all run to these bed alarms, sometimes we can't get there in time," says Cheryl Reinking, chief nursing officer at El Camino. Like most other US hospitals, El Camino had invested time and money in fall-prevention efforts, such as the call lights, but the various methods had not been effective enough. Read More

    Infection Prevention and Control: Remember Your ABC’s!

    Hand hygiene remains the most critical part of any IPC plan. Over the past 30 years of my professional career, performing hand hygiene has become so easy with the ubiquitous presence of alcohol foam containers for easy access. Yet it is still difficult to convince people of the importance of hand hygiene. I should not belabor the point; I am confident that your IPC practitioners do a great job of constantly reminding you of the importance of hand hygiene. Read More

  • June 27, 2018

    How Can We Keep Nurses From Burning Out?

    The nursing shortage has become a crisis. As the U.S. population ages, the number of people that require care is growing. Simultaneously, nurses are retiring in droves. The Bureau of Labor Statistics estimates that by 2022, 1.2 million roles for Registered Nurses (RNs) will be left vacant. The demand for nurses has outweighed the supply of new nurses for years, but recently, the issue has reached a fever pitch. Read More

    New Studies Illustrate Need for Rigorous Review of Infection Preventionist Staffing Models Across Healthcare Systems

    Severe gaps in staffing and outdated coverage benchmarks point to the critical need for evaluating and updating standards for infection preventionist (IP) staffing levels, according to two new studies that explored infection prevention and control resourcing across a variety of healthcare settings. A comprehensive staffing and coverage assessment conducted at Providence Health & Services, a large nonprofit healthcare system, revealed that actual IP labor needs were 31 to 66 percent higher than the current benchmarks system wide. Read More

    Study Reveals New Way to Inhibit Capillary Leakage in Sepsis

    Leakage from the blood capillaries is a key mechanism leading to septic shock and multiorgan failure, which affect millions of patients annually worldwide. However, there is no effective way to inhibit the vessel leakiness. A new study by scientists at the University of Helsinki and Wihuri Research Institute demonstrates that vascular leakage can be inhibited by targeting vascular integrins. Increased capillary permeability and subsequent leakage from the capillaries is associated with numerous difficult-to-cure diseases, including acute respiratory distress syndrome (ARDS), severe Dengue fever and malaria, and sepsis. Read More

    New Guidelines Address All Components of Nutrition for Critically Ill Patients

    A new nutrition bundle strives to ensure that critically ill patients receive adequate nutrition while hospitalized and seeks to reduce adverse outcomes related to malnutrition. More than half of patients admitted to critical care units are malnourished, which increases their risk for serious complications and contributes to longer hospital stays and higher healthcare costs. Yet many of those eligible to receive enteral feedings do not receive adequate nutrition while hospitalized. Read More

  • June 20, 2018

    Caring for Neurosurgical Patients with External Ventricular Drains

    External ventricular drains are life-saving devices used in neurosurgical patients with hydrocephalus (excessive amounts of cerebrospinal fluid). The fluid is produced in the brain ventricles and circulates around the brain and spinal cord, protecting them from injury and supplying brain cells with nutrients. Hydrocephalus can occur due to impaired circulation or malabsorption and is a medical emergency, which can lead to raised intracranial pressure. Nurses are responsible for the care of patients who have external ventricular drains. This article explains how the drains work and discusses key nursing considerations for their management. Read More

    New Test can Identify ICU Patients at Greatest Risk of Secondary Infections

    Patients in intensive care units are at significant risk of potentially life-threatening secondary infections, including from antibiotic-resistant bacteria such as MRSA and C. difficile. Now, a new test could identify those at greatest risk - and speed up the development of new therapies to help at-risk patients. Read More

    ICU Telehealth Reduces Interhospital Transfers

    Intensive care unit (ICU) telehealth was associated with fewer transfers of patients with moderate, moderate-to-high and high illness severity. Findings were published June 15 in Chest. ICU telehealth has been implemented in smaller community and regional ICUs to fill gaps in care, but investigations into its effect on transfers are lacking. In this study, researchers evaluated that impact. Read More

    New Study Identifies Gaps in Infection Prevention and Control at Critical Access Hospitals

    Critical access hospitals (CAHs) face significant challenges in their infection prevention and control (IPC) practices, according to new research presented at the 45th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). CAH is a designation given by the Centers for Medicare & Medicaid Services to rural hospitals with 25 beds or less that are located at least 35 miles away from other hospitals. Read More

  • June 13, 2018

    Vitamin C Trialed as Life-Saving Treatment Intensive Care Patients with Sepsis

    University of Otago, Christchurch researchers are teaming up with intensive care specialists to study whether intravenous infusions of vitamin C could be a life-saving treatment for patients with sepsis. Patients with septic shock are often given drugs to stabilize their cardiovascular function. Associate Professor Carr hypothesises that cardiac dysfunction, and resulting drug treatments, could be avoided if patients had appropriate vitamin C levels. Read More

    Social Media in Critical Care: What’s all the fuss About?

    The way we communicate and learn has been revolutionized by technology. Almost all of us carry a smartphone these days, so we are never more than a phone call, message or text away from family, friends and colleagues. This blog is the first of three from the authors examining how social media (SoMe) transgresses the usual borders and may, in the future, play an important role in communication, learning, teaching and peer review in anesthesia and critical care. Read More

    AACN Issues Practice Alert on Reducing Alarm Fatigue

    Excessive alarms are a threat to patient safety. New guidelines offer strategies to improve alarm management.Nurses working in acute-care settings are all too familiar with alarm fatigue, which occurs when clinicians are exposed to excessive amounts of alarms, particularly false and clinically insignificant alarms. In fact, studies estimate that approximately 90% of alarms in various critical care settings are either false or clinically irrelevant. Read More

    Hospital Staff Don't Always use Infection Prevention Gear Correctly, Study Finds

    Although hospitals supply staff with protective equipment to prevent infection spread, this gear is often used in the wrong way, a study in JAMA Internal Medicine found. To identify slipups with protective equipment, the research team observed inside and outside patient rooms in clinical units of two hospitals from March 2016 to November 2016. Mistakes included touching the face using contaminated gloves or gowns or entering a sick patient's room without protective equipment. Read More

  • June 7, 2018

    Pseudomonas Infections: Optimizing Diagnostic Strategies

    Peter L. Salgo, MD; Marin Hristos Kollef, MD; Andrew Shorr, MD; Yoav Golan, MD; and Jason Pogue, PharmD, BCPS-AQID, provide considerations for the optimal approaches to diagnosing Pseudomonas infections and identify where imaging and rapid diagnostics fit into the paradigm. What are the best imaging and other laboratory studies that you want in terms of knowing what’s going on and prescribing the right antibiotics? What’s the best stuff? Read More

    Rigorous Study Finds Widely Used Treatment for Infection Fails Young Cancer Patients

    A treatment designed to reduce bloodstream infections due to central venous catheters that had worked well in lab studies and is commonly used around the world, but had not been rigorously tested, failed to protect young cancer patients from recurring or new infections and left them at higher risk for complications. The study focused on the effectiveness of ethanol-lock therapy for treatment and prevention of bloodstream infections and related complications in pediatric cancer patients with central venous catheters, known as central lines. Read More

    Six Steps to Optimize Nutrition Support for ICU Patients

    A new nutrition bundle strives to ensure that critically ill patients receive adequate nutrition while hospitalized and seeks to reduce adverse outcomes related to malnutrition. More than half of patients admitted to critical care units are malnourished, which increases their risk for serious complications and contributes to longer hospital stays and higher healthcare costs. Yet many of those eligible to receive enteral feedings do not receive adequate nutrition while hospitalized. Read More

    Improving Patient Transfer from ICU to Ward: Resources, Communication and Culture

    A new study has identified important factors that can improve the transfer of patients from the intensive care unit (ICU) to a general hospital ward, a high-risk transition in which breakdowns in communication, medical errors and adverse events resulting in readmission can occur. The research, published in CMAJ (Canadian Medical Association Journal) includes patient and health care provider perspectives that identify resource availability, communications and institutional culture as key factors to be addressed. Read More

  • March 27, 2018

    Modified Biomaterials Self-Assemble on Temperature Cues

    Biomedical engineers have demonstrated a new approach to making self-assembled biomaterials that relies on protein modifications and temperature. The hybrid approach allows researchers to control self-assembly more precisely, which may prove useful for a variety of biomedical applications, from drug delivery to wound-healing. Read More

    How Rounding is Helping Hospitals Reduce Patient Readmissions

    Hospital readmission rates are declining and there are several contributing factors. One of the main factors is that reducing patient admissions within 30 days after being discharged from an earlier hospital stay, whether the patient is admitted at the same or a different hospital, or for a different reason, has been a tremendous focus with the implementation of the Hospital Readmission Reduction Program (HRRP). A provision in the Affordable Care Act established the HRRP, which requires the Centers for Medicare and Medicaid Services to reduce payments to Inpatient Prospective Payment System hospitals with excess readmissions in October 2012. Facing penalties and reimbursement reductions, hospitals have taken a proactive approach to ensuring readmissions are minimized. Read More

    Nanofiber Dressings Promote Skin Regeneration and Wound Healing

    As one of the largest segments of the population move into their six and seventh decades, advanced healthcare initiatives focused on wound healing are imperative to improve quality of life and help keep seniors active. Now, investigators from the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) and the Wyss Institute for Biologically Inspired Engineering have developed new wound dressings that dramatically accelerate healing and improve tissue regeneration. The researchers found that naturally occurring proteins in plants and animals can promote healing and regrow tissue. Read More

    Four of the Most Life-Threatening Skin Conditions and What you Should Know About Them

    Dermatological emergencies are uncommon, but can cause devastating complications and death if not recognised and treated early. Some skin conditions require treatment in an intensive care unit. Here are some of the most serious skin conditions and what you should know about recognising them.  Read More