The top story has to be the success of the Institute for Healthcare Improvement (IHI) in promoting implementation of evidence-based practices in hospitals to prevent infections, complications, and errors. In some hospitals, for example, ventilator-associated pneumonias have been virtually eliminated, mostly through consistent application of nursing measures like mouth care and positioning (see http://www.ihi.org for more examples). While controversy surrounds the IHI's claims of the number of lives saved by the "100,000 Lives Campaign" and the effectiveness of rapid response teams, the IHI initiative has undoubtedly improved hospital practices.

The approval of a vaccine against human papillomavirus (HPV) and its incorporation by the Centers for Disease Control and Prevention into vaccine recommendations for 11- and 12-year-old girls was expedient. But some oppose mandatory vaccination against HPV in these girls, saying that it may undermine the message that abstinence from sex is the best way to prevent HPV and other sexually transmitted diseases.

Evidence-based practices are enjoying wider application. Traditional practices are being evaluated in light of new evidence, with several now having data to support or discard their use.

* infant massage results in better sleep patterns and less crying (Cochrane Database of Systematic Reviews 2006, issue 4)

* treating croup with humidified air in the ED shows no benefit; no studies evaluating its use in the home have been performed (Cochrane Database of Systematic Reviews 2006, issue 3)

* calcium helps prevent preeclampsia (Cochrane Database of Systematic Reviews 2006, issue 3)

* heat can ease back pain, but little evidence supports using cold therapy (Cochrane Database of Systematic Reviews 2006, issue 1)

* evidence does not support using magnesium sulfate in labor, and some shows that it's harmful (Obstetrics and Gynecology, October 2006, affirming Cochrane Database of Systematic Reviews 2002)

Maureen Shawn Kennedy, MA, RN

news director