ARTICLES OF INTEREST

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ARTICLES OF INTEREST Powered By Docstoc
					                                    A R T I C L E S                         O F      I N T E R E S T


                  Pamela J. Haylock, PhD, RN




  Green, K.L. (2008). Summary: Procedural Sedation                        Hsu, J.L., Banarjee, D., Kuschner, W.G. (2008). Under-
Stakeholders Meeting. Journal of Radiology Nursing, 27,                standing and identifying bias and confounding in the medi-
130-131.                                                               cal literature. Southern Medical Journal, 101, 1240-1245.



C                                                                      T
         oncerns around patient safety, knowledge and compe-                    he emphasis on evidence-based practice makes it im-
         tency levels of persons administering sedation prompt-                 perative that we know how to interpret research find-
         ed several stakeholder organizations to participate in a               ings in the literature. Bias and confounding are types
national summit in June 2007 to discuss this topic and to guide        of methodological flaws in research that can lead to misinter-
the Emergency Nurses Association in developing a procedural            pretation and subsequent adverse consequences for clinicians
sedation consensus statement. Represented organizations in-            and patients. This paper offers “reader-friendly descriptions
cluded the American College of Emergency Physicians, Society           and examples” of these errors commonly found in reports of
of Critical Care Medicine, American Society of Pain Manage-            clinical studies. The authors define ”bias” as: “systematically
ment Nurses, Emergency Nurses Association, American Coun-              favoring some outcomes over others” that can be introduced
cil of State Boards of Nursing, and the Agency for Healthcare          in sampling and data analysis. “Counfounding” occurs when
Research and Quality, among others. Concerns had been voiced           an association between two variables seems direct, but in fact
to state nursing practice regulators about emergency nursesʼ           exists because of other unconsidered variables and leads to in-
competencies to administer sedative agents (propofal, ketamine,        terpretation errors. The authors remind us that as clinicians, we
fentanyl, midazolam). Components of the final document are:             need to try to assess the validity of reports before we apply
1) consensus statement supporting administration of sedative           clinical research findings to practice.
agents to emergency patients undergoing interventional proce-
dures; 2) a set of guiding principles focusing on patient safety
and patient-centered care; 3) definition of all terms used; and           McDaniel, C., Burkett, A.M., Cormier, M., Duvall, J.,
4) nursing role, knowledge and skills. The described process is        Davis, S., Gabriel, L., et al. (2009). PICC, the music and
a worthy model employing inter-organizational and interdisci-          travel to the port of relaxation: The effects of music on per-
plinary collaboration to influence policy and practice.                 ceived pain and anxiety in patients receiving PICCs and
                                                                       Port-A-Caths. Journal of Radiology Nursing, 28, 32-34.



                                                                       I
  Ainsworth S.B., Clerihew L. & McGuire W. (2007)                           n an attempt to increase patient comfort and reduce patient
Percutaneous central venous catheters versus periph-                        anxiety, nurses in an interventional radiology (IR) setting
eral cannulae for delivery of parenteral nutrition in neo-                  explored the effects of music on pain and anxiety rat
				
DOCUMENT INFO
Description: Represented organizations included the American College of Emergency Physicians, Society of Critical Care Medicine, American Society of Pain Management Nurses, Emergency Nurses Association, American Council of State Boards of Nursing, and the Agency for Healthcare Research and Quality, among others. Components of the final document are: 1 consensus statement supporting administration of sedative agents to emergency patients undergoing interventional procedures; 2 a set of guiding principles focusing on patient safety and patient-centered care; 3 definition of all terms used; and 4 nursing role, knowledge and skills. The author suggests additional risk reduction strategies that are useful beyond the perioperative setting: 1 implement strategies to manage storage and use of the sound-alike and look-alike medications heparin and hespan; 2 mix all medications in the pharmacy and/or use pre-mixed heparin solutions; 3 eliminate different concentrations of heparin in clinical areas; 4 conduct independent double-checks of all medications and dose calculations; and 5 conduct ongoing education about anticoagulation therapies for all staff.
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